HOEHNE — Between the passing bells, teen students gradually find their way to a second-floor classroom at the K-12 Hoehne School where they pause before entering, raise both hands and, one by one, greet instructor Dominic “Junie” Verquer with what could be considered the class mantra.
“BSI, is my scene safe?”
At first glance, the ritual might appear to be part of some school-safety drill or active shooter protocol — another dark reminder of a too-often violent and dangerous world. But the words repeated each afternoon as students arrive for Verquer’s hour-long tutorial hold the first key to their success.
For these juniors and seniors, the question reminds them of the first thing they absolutely must say when, sometime next spring, they take the National Registry test to become EMRs — emergency medical responders. BSI, short for “body-substance isolation,” and their raised hands, which in real-life situations would be gloved, indicate their readiness to assist.
“You have to say that when you walk in for the test — or you’re done,” warns Verquer, whose 30 years of experience with the Trinidad Ambulance District inform his role as instructor for about a dozen juniors and seniors with EMR aspirations. “So I want them to get used to saying it — every freakin’ day.”
He leaves nothing to chance, and for good reason. Las Animas County’s roughly 4,800 square miles — the most of any Colorado county — and sparse population make emergency response a difficult proposition. So five years ago, Verquer began teaching an EMR course that now includes rural high schoolers and others in the hope of reinforcing the county’s safety net with residents trained to stabilize a situation until more help can arrive.
In some remote areas of Las Animas County, the wait can approach an hour, even if trauma calls the Flight for Life helicopter buzzing to the rescue. Now that the area around Fishers Peak has become a state park, business figures to get even more challenging.
“This is a national issue, not just Las Animas County or southeastern Colorado,” says Brandon Chambers, coordinator for the Southern and Southeastern Colorado Regional Emergency and Trauma/Medical Advisory Council. “Every senior class, this should be a mandatory program. It teaches you things that have value in life that are important. I can’t overstate the importance of these programs.”
Every Tuesday through Friday, Verquer — who’s also the county coroner — drives about 10 miles from Trinidad to the 300-student Hoehne School and teaches from 1 to 2 p.m. in the four-day-a-week district. On Mondays, he heads 50 miles east of town to tiny Branson, in even more remote terrain, to teach an intense, 3½-hour class to 11 students at the Branson School and four adults from the community.
Emergency response isn’t for everyone, but those who like it tend to really like it. Verquer, 66, calls himself a “trauma junkie.”
“The thing they love about it is they’re first on scene,” Verquer says. “That’s the best part of this job. You take a patient to the hospital, they’re already kind of patched up. With EMS you’ve got the nitty-gritty right away.”
Branson, a town of only about 55 people, has been mostly without EMS coverage for about five years, since one certified resident moved away. Gaining new certified responders in Branson could restore coverage to the entire eastern part of the county, so Verquer got the go-ahead to expand his program there.
The goal: Once locals pass the course and get certified, the Trinidad district will pass down one of its retired ambulances to Branson, so it can staff its own QRT — quick response team — of volunteers scattered throughout the region.
Rachel Snyder, Branson’s mayor, sees that plan as a game-changer for trauma victims.
“We have people in their 70s who have been known to drive themselves to Trinidad because they don’t want to bother anybody,” she says. “Or sometimes people start heading to Trinidad and meet the ambulance on Highway 160. For us, it’ll give everyone peace of mind that, in case of a significant emergency, there’ll be someone.”
While Verquer recognizes that, among the high school students, some will leave the area for good to pursue college and careers, those who remain provide a valuable resource. One father-daughter combination who came through his first class remains active in the area. About 40 new EMRs have passed through his class, which nearly 85% of the students complete.
“That’s a big plus for us in the county,” he says.
Dave Bacharach, the fire chief in Hoehne, sees some of Verquer’s former students when they enroll at Trinidad State Junior College in the EMT course he teaches. Another student volunteers weekends on his department’s QRT.
Forty-five minutes west of Trinidad, in the Stonewall Fire Protection District, chief Loyd Holliman has regarded Verquer’s program with envy — until he finally got his own started this school year. Verquer trained one of the Stonewall EMTs to become an instructor.
“It’s a win-win-win,” Holliman says. “The students are loving it, the instructors are enjoying it. Hopefully with kids getting their EMR, we’ll retain some of them in the district.”
Holliman currently has only eight people certified as EMRs or EMTs in a district that covers 547 square miles. About 3,500 people live in his district’s remote, rugged terrain, which ranges in elevation from 6,000 to 14,000 feet.
“It would be great to have twice, three times that number,” he says. “We don’t feel like we ever have too many. Some departments put a cap on volunteers, but we’ve never reached that number. The more the merrier for us, as long as they’re capable.”
For students in Verquer’s class, the experience can simply expose them to a valuable life skill — or give them a helpful nudge toward a career in the medical field. And sometimes, it inspires students like Molly Felthager to go all-in on trauma treatment, with the firm intention of remaining in the area to become part of a network she has come to regard as family.
Before graduating in spring of 2018, Felthager took Verquer’s EMR course at the Hoehne School. She calls it “life-changing.” She knew she wanted to go into the medical field, but she wasn’t sure in what capacity.
Verquer’s class helped her figure it out.
“I originally thought I wanted to be a family doctor, but through the class I learned I like emergency medicine more,” Felthager says. “It’s so unexpected. I didn’t think I liked anything unexpected, I was more of a person who planned everything. But after seeing all the unexpectedness that comes with your day, it’s a lot more fun.”
Verquer recalls that her conversion wasn’t immediate. The first time she responded to a catastrophic death, on a ride along, “she was just torn to pieces,” he says. And the first time she interviewed a man who had just lost his wife, she cried right along with him.
Felthager says it was about halfway through Verquer’s class, at some point during a ride along, that she realized her place was in trauma treatment.
“I still want to be a doctor,” she says, “but I want to be an ER doctor now, that’s what changed through my EMR experience. Weird as it sounds, when you’re doing trauma, you realize you’re seeing people on the worst days of their lives, and I like being able to help them through that.”
Although she initially started college in Gunnison, she didn’t like it and dropped out. While waiting to enroll at Colorado State University-Pueblo, she got her EMT certification. Despite starting late, she finished at the top of the class.
“I trust her thoroughly,” Verquer says. “She knows what she’s doing.”
That’s why he hired her as his part-time, deputy coroner.
“I need a body.”
Back in Verquer’s classroom, the students have moved all desks aside to create a space in the middle where a collapsible stretcher now sits. Today’s lesson will teach students not only how to transfer an injured person to the stretcher, but also how to safely extricate them from a car.
At their teacher’s request, a volunteer sprawls on the floor and the students set to work once Verquer has explained how the latches and levers adjust the heavy-duty stretcher, and how a separate “scoop stretcher” can be assembled around the victim so they can be lifted onto the primary one.
“Sir, are you comfortable like that?” one of the students asks the patient, following protocol.
Once secured on the main stretcher, students wheel their classmate to a table, where they simulate moving them onto an emergency room bed. After the first few weeks of lectures, this hands-on lesson has the students pumped.
“I’m excited,” says David Hadaway, a senior and avid backpacker. “I’ve had to respond to medical emergencies in the backcountry before, but this will bring me into an urban area. There are so many gizmos and gadgets that I don’t know how to operate.”
The class begins by familiarizing students with the alphabet soup of acronyms and terminology they’ll encounter. But it moves on to a combination of biology and practical knowledge that encompasses everything from radio communications to privacy laws to hands-on procedures.
They’ll cover bleeding control, patient assessments, CPR, triage and, probably in the spring, learn how to deliver babies. In his 30 years of work, Verquer never had to deliver a baby, though he came close on two occasions. (He has, he adds, delivered many calves on his ranch.)
By December, they’ll have sufficient knowledge to participate in the required 12 hours of ride-along time with one of the Trinidad ambulance crews. One student joins a two-member crew for a day shift (no students ride after 8 p.m.), though they’re welcome to return as often as scheduling permits. One girl logged 100 hours.
“A lot of them will get the bug,” Verquer says.
Ty Mitchell, a senior, plans to use the knowledge gained in the class in his efforts to become a nurse practitioner.
“I want to get as much experience as I can,” he says. “My whole family is part of the medical field, so it’s part of who I am.”
Students also have the opportunity for a reality check. One morning each year, Verquer takes a group up to Pueblo, with a stop off at Colorado City for breakfast at Max’s Place. Then they continue on to St. Mary-Corwin Medical Center — to witness an autopsy.
If they’re hungry afterward, he treats them to lunch.
It’s not a mandatory activity, but most students take part after securing a release from their parents. By then, Verquer already has given them a tour of his coroner’s office and the city morgue, where they could come to grips with an emergency worker’s exposure to life and death. But there, they don’t go any further than the body bags.
In Pueblo, it’s the real deal.
“It’s a hell of an anatomy lesson,” Verquer says of the roughly two-hour exercise. “Most of them, they jump right in. That first smell is kinda rough. One young lady kinda leaned on me, getting heavier and heavier, so I escorted her to the bathroom. But she freshened up and came right back in.”
Alyssa Rivas, 19, who got EMR certified through the program and went on to get her EMT certification, is one of four graduates of Verquer’s class who works with the Trinidad Ambulance District. She vividly recalls the autopsy as “probably one of the coolest things I’d ever seen.”
“People don’t usually get to see that,” she says. “At first I thought I’d be grossed out, but I thought it was great.”
The EMR course also features a simulated mass casualty incident with cars, dummies and an area where students learn a difficult lesson about triage: Take one minute to assess each victim, assign them a color (red, yellow, green or black, based on condition) and then move on to the next one.
“You don’t take time in triage to treat anybody,” Verquer says. “They had a hard time accepting that.”
In April comes their practical exam, with hands-on response to a scenario before a group of proctors — pass or fail. (Definite fail if you forget: “BSI, is my scene safe?”) A written test follows for certification in the National Registry. Those who pass then petition the state, which requires no further exam, just a background check. All told, the cost for the certification comes to around $100, which is funded by a grant from a local benefactor.
After successfully completing those steps, the student gets a patch — but, according to superstition, doesn’t put it on their uniform. Verquer insists that’s bad luck, though he can’t say for sure where the notion originated. But students generally frame the ones they get for passing the national and state requirements.
The duplicate patches they buy next they wear — proudly.
“In September, they walk in like, ‘What the hell am I doing here?’” Verquer says. “By May, their responsibility and maturity level, it’s just amazing to watch. You’re in this class because you want to take it.”