By Jim Johnson
Monterey County Herald (California)
Copyright 2006 Monterey County Herald
Distributed by McClatchy-Tribune Business News
In an unusual alliance between a local fire department and the county’s ambulance service provider, the Salinas Rural Fire District and Westmed Ambulance are collaborating on a trial program that will place paramedics on fire engines.
Since taking over ambulance service in Monterey County this year, Westmed has struggled to meet its response time requirements in the sprawling Salinas Rural Fire district. That challenge led to discussions between the two emergency responders about how to cut down on the amount of time it took to get medical help to ill and injured residents in the fire district.
Salinas Rural encompasses about 250 square miles, including the Northern Salinas Valley, the Monterey-Salinas Highway corridor and the community of Chualar. It serves some 30,000 residents.
On Monday, the Monterey County Emergency Medical Services Council unanimously approved going ahead with the six-month trial program, which will elevate Salinas Rural’s emergency medical response level to advanced life support. Details of the program are being finished, and it will likely be implemented by Jan. 1.
Each of Salinas Rural’s three firefighter-paramedics participating in the program are fully certified and have been working part time for Westmed since the ambulance service began working with the county at the beginning of the year.
Salinas Rural will use Westmed equipment through the trial period, and until the fire district can purchase its own.
“We’re establishing a partnership (with Salinas Rural), and we’re very excited about it,” Westmed CEO Allen Cress said. “This has not been an overnight solution. We’ve been discussing this since March or April.”
Advanced life support means Salinas Rural’s three firefighter-paramedics will offer life-support services ranging from the use of manual defibrillators and endo-trachial intubation to administering a cadre of intravenous drugs. Salinas Rural firefighters are now limited to offering basic life support medical treatment.
The firefighter-paramedics will each work a different shift and be stationed at the district’s Laureles Station on the Monterey-Salinas Highway.
The program will allow Westmed to meet its response-time constraints under the terms of its contract, which requires a paramedic to arrive on scene within eight minutes or less 90 percent of the time.
Westmed was only making the eight-minute goal about 75 percent of the time and tried a number of changes in an attempt to meet its contractual obligations, Cress said, before settling on the partnership with Salinas Rural.
“If a paramedic gets on scene within eight minutes, regardless of what agency he’s from, we meet our goal,” Cress said, pointing out that Westmed then has a 12-minute limit to provide transport to a hospital.
Though Salinas Rural and Westmed have done preliminary analysis of similar programs, the trial period will allow the two agencies to collect and review its own data, according to County EMS Director Tom Lynch.
“The purpose of the trial period is to compare apples to apples,” Lynch said. “And they’ll be able to adjust the program as needed.”
The Salinas City Fire Department and Carmel Regional Fire Ambulance feature fully certified paramedics on their fire engines, but use their own equipment and training. Salinas City nearly cut its firefighter-paramedic program as part of budget cuts enacted in 2004.
Westmed replaced American Medical Response as the county’s ambulance service provider in January. AMR was hit by a wave of bad publicity stemming from allegations that employees were involved in illegal drug use or transport, revealed in a Herald investigation after an incident in 2002.
Salinas Rural will not transport patients as part of the new program.
Salinas Rural Fire Chief Mike Urquides declined to comment for this story, and said he preferred to wait until the program is finalized.