RESPONSE TO 911 CALLS EXPANDS; FIREMEN JOIN AMBULANCE IN RESPONDING TO MEDICAL EMERGENCIES

Beginning in mid-July, when a 911 call for emergency medical service is received by the central dispatch center in Cape Girardeau, a fire department pumper engine with medically trained and equipped firefighters will respond at the same time the ambulance is en route.

While the concept of a fire department emergency medical service (EMS) response is new to Cape Girardeau, the procedure should be familiar to viewers of the popular weekly TV series, "Rescue 911."

In cities and areas where the EMS procedure is used a fire department EMS team is dispatched after the EMS call is received, along with the ambulance, which may be operated by a privately-owned company or a public service organization.

In most cases, the fire engine or fire department EMS vehicle arrives several minutes ahead of the ambulance because the fire station is often closer to the scene than the ambulance. After their arrival, EMS-firefighters evaluate and assess the condition of patients and administer the level of treatment for which they are trained while the ambulance is en route.

"I see a need that our citizens have for this type of quick, emergency medical assessment response," said Cape Girardeau Fire Chief Robert Ridgeway. "And that's why we're implementing this service starting in mid-July.

Said Ridgeway: "Cape is a large city. It has become spread out geographically. We have four neighborhood fire stations that are strategically located throughout the city. Each is no more than 3 to 3 minutes away from any residence or commercial business.

"Our ambulance service is located in the northwest part of the city on a busy highway. When a EMS call comes in, it may take some time for the ambulance to respond because of the distance involved and the traffic. A pumper engine manned by our EMS-trained firefighters with EMS equipment on board can be on location in less than four minutes after receiving the call.

"We're in the business to save lives and protect property," Ridgeway said. "It only makes sense that if someone down the street from one of our fire stations has a medical emergency, and we have the necessary training and equipment to assist, then we're going to do it. It's foolish not to be going and assisting."

To prepare for the EMS response program, Ridgeway said the department will begin a 10-week training program next month to certify firefighters not already trained at one of the three levels of EMS training.

"There are three levels or tiers of EMS training," Ridgeway said. "The first level, or first responder, is trained to control and treat the basic ABCs of EMS:20airway, breathing and circulation, (bleeding) plus some splinting of fractures and other basic treatment.

"More importantly, first responders are trained to assess and evaluate the condition of the patient to determine the extent of injuries, and whether additional life-threatening injuries are present such as possible fracture of the neck or spine that could result in death or permanent disability if they are improperly moved."

Ridgeway said first responder training usually involves about 40-50 hours of classroom and practical training.

"The second level of EMS, the emergency medical technician, (EMT) involves at least 120 hours of training. In addition to performing anything a first responder can do, an EMT can ride on an ambulance and use more sophisticated equipment such as airways, MAST trousers and air splints. The EMT is considered a basic-life-support provider."

Ridgeway said the paramedic is the top level of the EMS20tier, and is considered to be an extension of the hospital emergency room physician. The paramedic is trained to perform functions that would be done by the ER physician in the emergency room, such as electro-shock and drug therapy for cardiac arrest. "Paramedic training involves a total of 1,500 to 2,000 hours of training, including academic classroom work and practical training in the ER room," he added.

"Right now the fire department has four paramedics, 17 EMTs and 20 first responders. Our first responder program that begins May 3, will train and certify the other firefighters who have no EMS training at this time and provide refresher training for those who are already certified as first responders."

Ridgeway said the training will be conducted by Firefighter and Paramedic Brad Golden.

"The program will be completed on July 16. It is our intentions to be ready to implement the EMS response program on Monday, July 19," he said.

"At that time we will have EMS jump kits on designated pumper engines at each of the four fire stations. When a 911 EMS call comes in, the pumper engine nearest the location of the emergency will be alerted at the same time the ambulance is on its way."

To prepare for the startup of the EMS response program, Ridgeway said a memorandum of understanding has been prepared and signed by all parties involved, including the fire department, Cape County Private Ambulance Service, St. Francis Medical Center, Southeast Missouri Hospital, Cape Girardeau20Police Department, and Dr. Charles Pancoast, medical control officer for Cape Girardeau and EMS coordinator for the region.

"This letter spells out in detail who does what, when, where and how. If a problem develops, it provides for a way to resolve the problem, but at this point, we do not expect any," said Ridgeway.

Pancoast said: "I think it's a definite step up for the people of Cape Girardeau. With the number of fire stations located around the city, and the ambulance service located in the northwest part of town, the response time for EMS care will be much faster. This is especially critical for heart attack patients who may be in cardiac arrest. The sooner that patient can be stabilized until the ambulance arrives, the better the chances of survival," he said.

City Manager J. Ronald Fischer said the concept of a fire department EMS response mission was first discussed by former fire chief Gene Hindman. "This is something that we've been looking at for some time," he said. "When Bob came to us earlier this year, he picked up where Gene left off and has accelerated the training and planning for the program."

Ridgeway said the entire fire department EMS response program can be operated for about $5,000 per year. Most of that will involve replacement and restocking of medical supplies.

The fire chief emphasized the EMS response program will augment, and not compete with the private ambulance service.

"The fire department will not be in the business of transporting the sick and injured, or responding to a routine transfer call," he said.

Cape County Private Ambulance Service Manager Mike Craig said the fire department EMS response program will help the operation.

"We're always glad to have extra hands at the scene of a medical emergency," said Craig. "Our call load has increased throughout the county, and on occasion we do have some delayed responses. This will help us in our coverage of the county and the city of Cape Girardeau," Craig said.

Although the fire department will not charge for its EMS services, patients who are treated and transported by the ambulance service will continue to be billed for the service, as is now the case, Ridgeway said.