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On the scene in 9 minutes flat — or less
by Megan Tilk
Sunday, August 10, 2008
Mike Webb and John Harris load a patient into their ambulance in this photo from last year. Ambulance response times have improved with the addition of more ambulances and ambulance-waiting locations, according to Heartland Health.

Photo by Eric Keith / St. Joseph News-Press / Purchase this photo

Mike Webb and John Harris load a patient into their ambulance in this photo from last year. Ambulance response times have improved with the addition of more ambulances and ambulance-waiting locations, according to Heartland Health.

Vickie Pickett remembers a day when waiting for an ambulance could sometimes seem like forever. Now, sometimes they arrive before she’s ready for them.

Ms. Pickett is a night medic at the Vintage Garden South assisted living center. She joined Vintage Garden South three years ago and remembers waiting several minutes with her elderly patients before an ambulance would arrive.

“I just called one not too long ago, and they were here before I had the paperwork ready for them,” Ms. Pickett said.

About three years ago, Heartland Regional Medical Center received numerous complaints from citizens and from the St. Joseph Fire Department about ambulance response times. Heartland officials decided to make some changes, and they hired Tom Little as the director of ambulances.

Mr. Little was notified of 59 different concerns that Heartland needed to address with its ambulance department. He says now almost all 59 concerns have been addressed, including the addition of two more ambulances and new ambulance-waiting locations in the city.

For a majority of the day, Heartland has four different ambulances on standby at various locations. They also have the help of the Fire Department’s first responders on every call.

Mr. Little said there is a great need for the assistance of the Fire Department to be on every call.

“It’s crucial to have them there,” Mr. Little said. “They can get there almost three minutes ahead of us.”

Although Fire Department responders aren’t allowed to transport patients, the extra time they are there allows for initial care and assessment prior to a Heartland ambulance crew arriving to take the patient to the hospital.

How quickly the Fire Department arrives at an emergency is important, because statistics show Heartland ambulances still are coming up short in one national standard. Heartland tries to get to life-threatening situations (also called priority one calls) in less than nine minutes 90 percent of the time.

From July 2004 through June 2005, Heartland responders made it to life-threatening scenes within nine minutes just more than 60 percent of the time. Since July 2006, Heartland has made it to priority one calls within nine minutes more than 85 percent of the time.

The goal is to arrive at priority two calls, or non-life threatening situations, in less than 12 minutes. They have met their priority two goal 100 percent of the time since July 2006.

Those numbers have made the job a little more difficult for the Fire Department.

“We’re really having to hustle to beat them now,” said Steve Daniels, chief training officer for the Fire Department.

Responders from the Fire Department often use firetrucks as their transportation to a medical call, which Mr. Daniels says sometimes slows them down. However, getting smaller vehicles doesn’t appear to be an option.

“We don’t have the space,” Mr. Daniels said. “A lot of the (fire) stations are single structure buildings that just don’t have enough room for an SUV or car for us to drive on medical.”

There is one truck and one sport utility vehicle in the entire Fire Department that get used for medical calls, Mr. Daniels said.

Mr. Daniels isn’t fond of the idea of sending out a $3.25 million piece of fire equipment on a medical call.

“We’re taxpayers too, and if there were a better idea, we would take it,” Mr. Daniels said.

Even with the expense, Mr. Daniels also feels the need for both sets of responders — the Fire Department and Heartland ambulance crews.

“The two people that ride in a Heartland ambulance may not be enough to handle the situation,” Mr. Daniels said.

The Fire Department sends a minimum of three people on a medical call, which can come in handy with multi-victim situations or serious wrecks, he said.

According to Mr. Little’s statistics, the Fire Department responders have met their goal of a six-minute response time 87 percent of the time since December 2007.

Mr. Daniels would like to see that number improve to 95 percent of the time. He’d also like all firefighters to become emergency medical technician (EMT) certified. Currently, about 70 of the 132 firefighters have that certification. Mr. Daniels said it is now a requirement for all new firefighters to be certified.

Another change Mr. Little made was to EMT certify all dispatchers who take the 911 phone calls.

When a resident calls 911 for a medical emergency, the call first goes to the St. Joseph and Buchanan County Law Enforcement Center before it is routed to Heartland to dispatch an ambulance.

“It’s important to have EMT-certified dispatchers, because if it’s a case where they have assessed by phone that a baby needs CPR, they can give the caller instructions to get it started before first responders even arrive,” Mr. Little said.

While there is still progress to be made, Mr. Little said the accomplishments of the ambulance department are great.

“Heartland gets no tax dollars to run its ambulance crews,” Mr. Little said.

The department runs off a $3.5 million operating budget each year and saw a $1.2 million dollar loss (expenses over patient fees) last year.

With high gas prices, Mr. Little said it now costs about $186 a day to fill each ambulance with diesel fuel.

Regardless of the cost and grief taken, both Heartland and the Fire Department feel they must continue to support each other.

“This town’s not big enough for two ambulance services, and the one it has needs everything it can get to continue running,” Mr. Little said.

Megan Tilk can be reached at megantilk@npgco.com.

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Posted by DADicated on August 10, 2008 at 2:58 a.m. (Suggest removal)

It is reassuring that ambulance response times are improving.

“This town’s not big enough for two ambulance services..." Thank you for the laugh.

There are many options for ambulance service. Fire Departments in many areas run the ambulance service (this would possibly be feasible for St. Joseph, but the rural areas of the county rely on volunteer firefighters, resulting in unmanned firehouses). In the City, ALS (Advanced Life Support) fire engines equipped with paramedics and specialized drugs and equipment could be implemented (that also wouldn't help the rural areas). A countywide EMS District could be formed. This is a norm in many places.

There is training available to 911 dispatchers to give pre-arrival instructions to callers, called EMD (Emergency Medical Dispatch). It is available through a number of professional organizations, and must be approved by a local physician.

Running a big giant fire truck to an ambulance call is the norm. For a vehicle accident, the truck's water or rescue equipment may be needed (sometimes you don't know until you arrive on the scene). If an SUV is sent to 6789 Anystreet for a medical call, what happens if right after they are done with that call there is a house fire at 6788 Anystreet? I think I would want that big giant fire truck there.

Finally a huge Thank You to the men and women of our ambulance service and Fire amd Police Departments. You are proof that there are angels among us.

Posted by TFurguson on August 10, 2008 at 8 p.m. (Suggest removal)

Good comment DAD


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