- Your News
By MARIAN GALBRAITH
Coffee County Emergency Medical Service (EMS) director John Cathey and Ambulance Authority chairman Jimmie Bradford recently revised an agreement with the Tullahoma Fire Department by adding another category of medical emergencies for which the fire department’s first response team will be dispatched with the ambulance.
While city officials were grateful for the change and unanimously accepted it, some feel that the addition is somewhat overdue as well as inadequate.
Tullahoma Fire Chief Richard Shasteen said this still leaves 20 other medical categories that EMS and the Ambulance Authority still will not include in the agreement.
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“We initially submitted a list of 25 criteria that we wanted our first responders to be dispatched for immediately, along with the ambulance, so that there’s no delay,” Shasteen said.
“The county initially approved only four of our criteria for simultaneous dispatch, along with a few other criteria of their own, but now they have decided to add another one from our list, namely unconscious/unresponsive.”
“We’re happy they’ve added this, we’ll take anything we can get, but if it’s not added as a simultaneous dispatch, there will still be room for delays, and that’s what we’re trying to avoid.”
City Administrator Jody Baltz said he did not fully understand why Bradford and Cathey did not include the first response team for all 25 criteria several years ago, when the agreement was first discussed.
“Our board of mayor and alderman have basically been unanimous in their support of having all the criteria included,” Baltz said, ” so I don’t know why Bradford and Cathey won’t go along with it, but it’s their department and their call.
“We’re just interested in saving lives as much as we can, that’s all.”
If the first responders are dispatched immediately with the ambulance, Shasteen said his crew can sometimes reach the scene several minutes before the ambulance arrives, and can begin cardio-pulmonary resuscitation (CPR) and other methods to stabilize the patient until the ambulance has time to get there.
Unbeknown to many, the fire department’s state-certified first responders are specifically trained to support their local ambulance service, particularly in rural areas where they may be able to reach and stabilize a patient sooner than the county ambulance can get there.
First responders can perform CPR and other forms of medical rescue and are equipped with oxygen tanks, defibrillators, and other medical devices designed to help save lives, especially in the crucial moments of an emergency situation.
“In some cases, just having a uniformed person show up can help calm a patient down, stabilize their breathing and reduce their heart rate, and that alone can have a favorable outcome on the situation.”
While Bradford also states that he is “just trying to save lives,” he said he feels this argument has been “blown out of proportion” over the years and sees no need for the first responders to try to get to the scene ahead of the ambulance in so many situations.
“I don’t see why the fire department needs to be called so much,” Bradford said, “and I don’t really care if they get there a minute or two before we do.
“Even though they are trained as EMTs, they don’t work for Coffee County EMS, they are firemen, and they don’t need to be there with us for every type of emergency.
“We have worked to include them in several categories of emergency situations, and we feel the arrangement has been working well so far.”
The 25 criteria initially requested by Tullahoma officials for simultaneous dispatch include:
* Airway obstruction
* Allergic reaction / Anaphylaxis
* Carbon monoxide inhalation
* Cardiac/respiratory arrest
* Chest pain (cardiac related)
* Diabetic emergency
* Severe difficulty breathing
* Drowning/water emergency
* Falls greater than six feet
* Imminent childbirth (including miscarriage)
* Industrial/machinery accident
* Motor vehicle collision
* Pedestrian struck
* Penetrating wound (i.e. gunshot, stab, etc.)
* Stroke alert
* Suicide attempt (life threatening)
* Uncontrolled hemorrhage
The current agreement only includes four criteria for simultaneous dispatch, namely motor vehicle crash with injuries, any accident involving entrapment, CPR in progress, and multiple casualty incidents.
In addition, EMS agrees to dispatch the first responders, “when there will be a delay in the response of the ambulance,” “when extra manpower may be needed, as in the case of multi-level structures, obese persons, etc.,” “anytime the responding ambulance crew requests them for whatever reason, and “when a patient is unresponsive or unconscious,” but these four criteria do not require simultaneous dispatch.
“If they don’t dispatch us at the same time they dispatch the ambulance,” Shasteen said, “then there will still be a delay, especially if they’re going to be pursuing more non-emergency work with the same vehicles.”
Shasteen was referring to the fact that Bradford and Cathey have requested an additional $101,000 in the annual budget process for two new drivers, plus associated personnel costs, for the stated purpose of pursuing more non-emergency transports.
“That’s what we’re trying to minimize is any delay, especially if someone is unconscious,” Shasteen said. “That’s when every minute really counts.”
Shasteen said he was not sure if the updated agreement has been received or implemented by the county’s 911 Communications Center, which is responsible for actually making the dispatch call, but that he hopes it will be fully implemented as soon as possible.