By Don Eriksson
The Lowell Sun
PEPPERELL, Mass. — The Fire Department Ambulance Company, bolstered by a steady influx of young EMTs interested in maximizing their skills and a steadily increasing annual call volume, is on the verge of blossoming into a paramedic-level force that will bring mobile emergency-room capability to trauma victims before they reach a hospital.
It is eminently doable, company Capt. Jean Taubert and Lt. David Hargraves told selectmen last night — and it could save the town tens of thousands of dollars being paid out to external medic-level providers.
They must wait for a go-ahead until the Board of Selectmen meeting of Oct. 13, though, as selectmen double-check what seems like a no-brainer, Chairman Joseph Sergi said.
Several years ago, the ambulance service became part of the Fire Department as a separate company, like the Hook and Ladder and Engine Companies, which, in Pepperell, was a relatively seamless transition from full autonomy.
It has operated as an advanced life-support, or ALS, service for nearly a decade, with EMTs licensed at both the basic and intermediate level who staff two ambulances around the clock.
In the past several years, the company roster has grown to include three paramedics in its mix of six intermediates and 27 basic licensed personnel.
Unlike basic and intermediate-licensed personnel, a paramedic can administer multiple types of intravenous fluids and emergency medications, similar to a doctor, and can offer advanced airway management, as well as cardiac care and monitoring. They undergo 1,000 hours of training in a two-year academic program.
Pepperell depends on contracted paramedics as needed, according to a priority list that starts with Medstar Ambulance, then Townsend’s Fire/MEDIC 1, Ayer Fire based in Groton, Hollis Fire, then Rockingham Regional Ambulance in Nashua.
State guidelines have increased transport times, Taubert said, reducing contractor availability and adding a burden to local communications personnel to locate help, and hard fiscal times have greatly increased the payment/reimbursement schedule.
The use of intercepts — in which a paramedic ambulance meets a Pepperell ALS ambulance somewhere en route to a hospital — is difficult and ineffective, Taubert added.
According to a chart presented by Taubert and Hargraves, the average time for a Pepperell ambulance to respond is 4.22 minutes. The average time for a paramedic unit to arrive at a patient is 21 minutes for Medstar, 23 minutes for Townsend and 24 minutes for Ayer.
Use of the five contracted paramedic services cost Pepperell $37,272 in 2009, Taubert said. That figure is estimated to become $68,000 in 2010, at an average of $250 to $350 per call, versus $93 to $150 this year.
A change to a paramedic-level service will include the annual $600 state license currently paid, an initial $800 outlay for advanced medications, and the purchase of a refurbished cardiac monitor/defibrillator for $10,000 or lower, for which fundraisers are already being planned.
Fire Chief Toby Tyler estimated payroll differential at $5,802.
At first, a waiver application to allow use of one paramedic and one lesser-licensed EMT per ambulance, instead of the state-mandated two paramedics, will be sought. One of the two ambulances will be paramedic-equipped, and grant money will be sought to equip the second.
Paramedic equipment is easily transferred between vehicles, and that practice is already in place to spread out wear and tear between the two, Hargraves said.
“The state is coming up with more training all the time, and both Jean and I have set up paramedic services elsewhere,” he said.
“I keep waiting for the other shoe to drop,” Selectman Joseph Hallisey said.
“There really isn’t one,” Taubert said. “We can always drop down to intermediate level again. Pepperell is up to date with command quality control, way ahead of the game.”
Eight or nine years ago, Pepperell examined paramedic-level service when there was just one paramedic and a lot of questions.
“For a small department, we’re doing a heck of a job,” Hargraves said. “There is no reason not to go for the gold ring again.”
“So if you get a yes next meeting, there’s no loss for the town?” Sergi asked.
“Correct,” Taubert said. “We need the Board of Selectmen behind us.”
“If it’s no,” said Deputy Fire Chief Jonathan Kinney, "$68,000 will have to be paid out.”
Copyright 2009 MediaNews Group, Inc.
All Rights Reserved