EMS department stretched thin

An article by Connie Beard published April 30, 2008 by The Paris News shows how Georgia's citizen's health can be put in danger by the Legislature's unwillingness to adequately fund emergency medical services.

http://www.theparisnews.com/story.lasso?ewcd=e1a494132412308a


Two motor vehicle accidents with multiple injuries and an isolated emergency call stretched the city’s ambulance service a little thin yesterday.

“We staff three front-line mobile intensive care unit trucks 24-7,” said Kent Klinkerman, director of emergency medical services for the City of Paris. “We also have a transfer division truck staffed Monday through Friday for non-emergency calls, for clinics, doctor offices and dismissals.”

Two wrecks, one on the west side of town on U.S. 82, the other on the east side on Lamar (U.S. 82), required the use of all three ambulances. The non-emergency truck with advanced life support also was dispatched.

The city’s emergency back up plan was put into effect when dispatchers received a third emergency call — this one from Powderly.

“We have a crew assigned on call. They carry pagers and are available 24-7,” Klinkerman said. “They were paged Priority One (drop everything and come in). In the meantime we had a truck cleared off the accident scene, which went to Powderly.”

Klinkerman said the delay was only two to three minutes and a first responder crew was already en-route.

The city’s ambulances are capable of transporting multiple patients. Two of the ambulances each carried two or more people Tuesday, freeing the third ambulance for the Powderly call.

The EMS department also has a plan for more critical situations. All 35 personnel in the department carry pagers. When an emergency requires, an “all-call” tone is sent to the pagers, calling in all off-duty personnel.

“We didn't get to that point today,” Klinkerman said.

A few years back, the all-call protocol was used for the Navarro college team wreck. That incident injured 12 to 15 and everybody was sent in. All personnel were called in and ambulances ferried patients until all of them were transported to medical care facilities.

For even larger disasters, such as the 1982 tornado, the director activated the mutual aid agreement, bringing in the assistance of private ambulance services and other aid as was needed. “We haven't had a mutual aid situation recently. We try not to have to rely on entities outside the county,” Klinkerman said. “Most of the mutual aid Paris participates in is for outside the area, including ambulances dispatched during the Katrina disaster when they were shipping evacuees on buses.

“We sent ambulances to Texarkana, Atlanta, Texas, Florida and Galveston when they evacuated off the coast.”

Klinkerman is planning a practice disaster drill next month.

Response time is one yardstick by which ambulance systems are evaluated.

“Inside Paris, somebody with medical training arrives within five minutes. Outside Paris, first responders arrive in five or six minutes while we’re on the way to there,” Klinkerman said.

To achieve acceptable response times in the city, crews are housed in various locations, usually more in outlying areas. Ambulance crews don’t have to deal with as much traffic and stoplights from those places and are able to achieve quicker arrivals.

“When we added a third emergency crew in 2000, we housed them with the fire department on Pine Mill Road. It reduced response times four to five minutes due to the traffic and lights,” Klinkerman said. Launching from that location also cut time to Blossom four to five minutes.

“We have a good system to rapidly get assets to deal with whatever situation happens locally,” Klinkerman said.

Eighteen first responder groups in the county are registered with the state. First responders are usually closer to areas such as Roxton or Deport. Those responders assist patients until Paris EMS can arrive.

Call volume for emergency responders has increased the last few years. According to Klinkerman, they received 7,500 calls two years ago. Last year they had 8,000 calls. The volume for this year is already at 9,000.

Klinkerman attributes the increase to an aging population and to the area’s industrial, medical and college student base. Even with the increase in calls, Klinkerman says there won’t be an increase in crews or trucks this year, although he might have to increase the non-emergency truck hours to better accommodate the volume.

“If we have another 10 percent increase in call volumes,” Klinkerman said, “we may have to look at it in 2009 or 2010. If I could afford it I would love to add another crew, but I just can’t justify the cost.”

The EMS director said he currently offsets the cost of running the department by revenue generated from calls. He evaluates responses every day to “make sure we deliver quality medical care in a timely and efficient manner.”

Klinkerman added, “We staff for what is actually happening on a daily basis. We staff for what is, not for 'what if.'”