Officials defend city rescuers
By Mark Melady
Telegram & Gazette (Massachusetts)
Copyright 2006 Worcester Telegram & Gazette, Inc.
All Rights Reserved
WORCESTER, Mass. — The city often over responds to non-life-threatening medical emergencies with a firetruck, police cruisers and an ambulance, leading to costly inefficiencies, according to a survey of Worcester’s first response system.
However, the findings are disputed by fire officials as “pennywise and pound foolish.”
The report by The Research Bureau, which studied first response plans in 35 cities, recommends the city system be restructured, giving the city manager greater authority in emergency medical response and reducing the role of the Fire Department.
Last year, 66 percent of the Worcester Fire Department calls were for medical emergencies, slightly more than the national average of 62.3 percent. In 2005, Worcester police medical calls amounted to 5 percent of the department’s total calls of 97,645. Ambulance service is provided to the city free by UMass Memorial Medical Center.
“At times the arrival of three different vehicles to the scene of a medical emergency,” the report concluded, “can result in confusion for the patient involved and in the minds of the general public. Who’s in charge? This situation diverts personnel who may be needed for more serious emergencies.”
Fire Chief Gerard Dio said the Fire Department, with its stations scattered around the city and its men trained to treat the injured, makes it an ideal delivery system for first response.
“We’re strategically located throughout the city to get anywhere in less than 4 minutes to stabilize a patient or even just for simple care,” Chief Dio said. “We have 150 firefighters trained as EMTs or further up the scale of medical education and training. It would be foolish not to have us respond.”
Chief Dio acknowledged two police cruisers, a firetruck and an ambulance at the scene of a relatively minor car accident can leave the impression of too much response.
“Granted there may be overkill at times,” Chief Dio said, “but that’s the nature of the game. The persons who are being cared for are not complaining. How much is that life worth? Can the municipal research bureau put a value on that life?
District Fire Chief John F. Sullivan, the department lead spokesman on emergency medical response, said firefighters responding to a medical emergency are performing dual duty. “They’re still firefighters. Once the victim is in the ambulance, the firefighters are ready for other calls,” he said.
Changes recommended by the report include: making the city manager chairman of the Emergency Medical Services Committee; establishing specific criteria and clear protocols for emergency dispatch to prevent over-response; improving dispatcher training and equipping police cruisers with defibrillators.
District Chief Sullivan said the department uses first responder protocols that meet national standards; that dispatcher training is in place and that police do not carry the heart-starting defibrillators because their contract with the city does not call for the same $250 stipend paid defibrillator-trained firefighters.
As for the city manager chairing the Emergency Medical Services Committee, District Chief Sullivan said, “We’d love to have him but it’s so far down on the management tree, I don’t know if he’d want to.”
District Chief Sullivan, an EMT for 24 years who teaches the subject to city firefighters, said the report noted the department’s success in response time and saving the lives of heart attack victims.
In 2005, the department’s average response time was 3 minutes and 39 seconds - good compared to the times of the 35 other departments reviewed by the bureau researchers. The high was 5 minutes and 21 seconds in Sunnyvale, Calif., and the low was 3 minutes flat shared by Boston, Springfield and Lynn.
The other performance category examined by the report was cardiac survival. Worcester had a 16 percent cardiac arrest survival rate, fourth best among the departments reviewed, and well above the national average of 6 percent. Rochester, Minn., had the highest - 43 percent
“Having the Fire Department be a first responder is worth every dime when it comes to services provided to the citizens of Worcester,” District Chief Sullivan said.