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Pulling paramedics off shifts appears unique to D.C.
While data provided by the D.C. Fire and Emergency Medical Service Department show the volume of medical calls doubles during the day — from an average of 10 per hour overnight to about 20 per hour between 1 and 7 p.m. — Mr. Werfel said the ebb and flow of the severity of the medical calls received should also weigh into a redeployment plan.
“The call index of severity is much higher at night than it is during the day,” Mr. Werfel said. “At night, when someone gets woken up in the middle of the night with chest pain, that’s a real [advanced life-support] call. What he should be looking at is not how many calls, it’s about the nature and severity of those calls.”
Calls requiring advanced life support usually involve severe and life-threatening situations, such as heart attacks or trauma. Paramedics are trained to perform more complicated medical procedures and to administer drugs, as opposed to EMTs, who respond to calls involving more common injuries and illnesses. Medical calls that come in during overnight hours tend to be more acute in nature and patients can better benefit from the help of a paramedic over an EMT, both Mr. Werfel and Mr. Romano said.
“A lot of the daytime calls, which may come through 911 as being cardiac, they often turn out to be less than acute emergencies,” Mr. Romano said. “They are not of the moment-by-moment criticality where a paramedic means a difference.”
In response to questions about whether the D.C. fire department also reviewed data on the nature and severity of medical calls, Mr. Walls said the department considers all advanced and basic life-support calls important.
Don Lundy, president-elect of the National Association of Emergency Medical Technicians, said that with fire and EMS departments across the country currently grappling with paramedic shortages or smaller budgets due to the economic downturn, it’s important for agencies to think outside the box for a solution.
South Carolina’s Charleston County, where Mr. Lundy works as EMS director, restructured its own response strategy in 2009. After tracking three years worth of data on call volume, location, time and type, the county removed ambulances from rural areas replacing them instead with rapid-response vehicles equipped with many of the same medical tools as an ambulance. The vehicles, which do not transport patients, allow paramedics to respond faster and treat patients while ambulances are en route. Once transported, the rapid-response paramedic would stay in the coverage area rather than accompany the patient to the hospital a move that allows the paramedic to go right back into service.
The strategy immediately shaved an average of two minutes off county EMS response times.
Comparing Charleston’s plan to the plan in the District, Mr. Lundy was skeptical of the reliance on fire trucks to transport the cross-trained firefighter-paramedics.
“To roll a fire truck, that’s a $400,000 vehicle. That’s an awful expensive resource to go out on a single-source call,” he said. “A paramedic on a single-source vehicle, they would probably see as more cost efficient.”
Mr. Werfel lamented that more information is needed about the District’s plan, especially about the data on call severity, before they would be able to give stamp of approval.
“I would be willing to support it if you can show it’s not just less calls but also lesser call severity, but right now there is not enough information to support it,” Mr. Werfel said. “Right now it just seems like this is a whim.”
© Copyright 2013 The Washington Times, LLC. Click here for reprint permission.
About the Author
Andrea Noble is a crime and public safety reporter for The Washington Times. She can be reached at firstname.lastname@example.org.
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