NC firefighters respond to growing number of medical calls
In North Charleston, medical calls have quadrupled in five years
By David Slade
Post & Courier
CHARLESTON, N.C. — We call them firefighters, but at fire departments across the area, the majority of emergency calls they now answer are for medical assistance.
In large urban departments across the Lowcountry and at smaller rural ones like the St. John's Fire District, medical calls have been growing fast due to a growing, aging population, changes in emergency dispatching, and a lack of preventive medical care among patients, fire officials say.
In North Charleston, medical calls have quadrupled in five years, and last year outnumbered building fires by 35 to 1.
"In a sense, firefighters are becoming primary care providers," said North Charleston Fire Chief Gregory Bulanow. "This has, no doubt, put increasing demands on our resources."
That's an issue for the departments and for the taxpayers who fund them.
Some departments are responding by searching for more efficient ways to handle the soaring call volume.
Larger departments in particular are moving away from the long-time practice of dispatching a crew in a fire engine when there's a medical call.
Mount Pleasant and North Charleston have started outfitting sport-utility vehicles for firefighters, so that a crew won't have to use a $500,000 fire engine that gets 5 miles to the gallon to answer a 911 call about someone having chest pains.
Using the SUVs also keeps firetrucks available for fighting fires.
Mount Pleasant currently has one SUV for medical calls and another on order. North Charleston has two and one more on the way. Mount Pleasant Fire Chief Herb Williams said that with three, the town could handle most medical calls without using fire engines.
Bulanow said the first SUV "special response vehicle" that North Charleston had was already handling 17 percent of the city's medical calls, covering the territory of multiple fire stations. They took delivery of the second vehicle on Friday.
Firefighters Shawn Krajic and Alec Dunn were staffing that vehicle recently, voluntarily working a 12-hour overtime shift.
"We usually roam the area," Dunn said, rather than waiting for calls to come in.
Firefighters often reach the scene of a medical emergency faster than an ambulance, saving minutes that can be crucial in responding to a heart attack, stroke or trouble breathing. The firefighters, many of whom are certified paramedics, provide life-saving services while awaiting the emergency medical service crew.
"We get there sooner, and we have more firefighters than they have EMS," said Williams.
He said the town's fire department handled about 6,000 total calls last year, and roughly 70 percent were medical-related.
"I think one thing is that the population is aging, and the population has also grown - exploded, really," he said. "More people and older people will equal more medical calls and more medical assists."
The serious calls
Firefighters in most areas are only dispatched for medical emergencies that are life-threatening or involve car wrecks. In North Charleston that amounts to between a third and a half of the 911 calls Charleston County EMS gets within the city.
"We do depend on fire departments for first response capabilities," said Charleston County EMS Director Don Lundy, who also is president of the National Association of Emergency Medical Technicians. "The fire department, in critical calls, can start the treatment before we get there."
Jim Lake, who is in charge of Charleston County's consolidated emergency dispatching center, said medical calls county-wide have been rising by about 3,000 yearly and hit 47,000 in 2012.
Bulanow said it appears that before emergency dispatching was consolidated, some calls in the city weren't getting to the Fire Department. In 2007, for example, North Charleston was dispatched for only about half of the EMS calls described as life-threatening emergencies.
Now, city firefighters are dispatched to all such calls, plus many of the calls involving life-threatening potential, as determined by national standards.
"Because we are getting good information and standardizing protocols, agencies are getting more calls," Lake said. "We are getting the right units on the scene, and probably sooner."
Lundy said people who don't have health insurance or can't afford time off from work for doctor's appointments are one reason calls are increasing. Instead of getting preventive care for conditions like diabetes and heart disease, people call 911 when their blood sugar crashes or a heart attack strikes.
On Johns Island and surrounding barrier islands, the St. John's Fire District handles about 2,500 calls for service each year, and these days more than half are medical calls.
"For us, we run 50-55 percent of our calls as EMS calls," Administrative Chief Wayne Carter said.
A decade ago, medical calls were closer to one-third of St. John's calls. In Charleston, medical and rescue calls accounted for 45 percent of the Fire Department's calls in 2008, but more than 60 percent in 2012, when the department handled 9,914 medical calls.
Just last month, the city hired a director to manage the medical component of the Fire Department's work.
Battalion Chief and Fire Marshall Mike Julazadeh said the city had made a decision to respond to a broader range of medical calls, and that's one reason for the growth.
"I think you are going to see (the calls) level off at some point, but the aging population is continuing to grow, and we are a popular region for retirement," Julazadeh said. "I would not expect that it's going to double again, but it probably will increase."
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