RIALTO: Officials saving ambulances for emergencies

RIALTO: Officials saving ambulances for emergencies

STAN LIM/STAFF PHOTOGRAPHER
Rialto Fire Department Firefighter/Paramedic Marcus Lynch helps guide in the cities ambulance after finishing up a call on Friday, Nov. 2, 2012 in Rialto. Starting Monday the fire department will be reserving its ambulances for true medical emergencies.
BY RICHARD BROOKS
BY RICHARD BROOKS The Press EnterpriseSTAFF WRITER

rbrooks@pe.com

Published: 04 November 2012 03:10 PM

Anxious to keep his city’s three paramedic ambulances available for medical emergencies, Rialto’s fire chief no longer is sending them to treat broken fingers and other minor problems.

“I’m still going to send a paramedic to every call,” Chief Mat Fratus emphasized. “But I’m not going to send multiple paramedic units to every call.”

Beginning Monday, Nov. 5, dispatchers will assign only a paramedic fire engine to minor medical calls in Rialto. The aim is to keep the three Fire Department ambulances available for more serious emergencies, including heart attacks, strokes, injury traffic crashes and violent crimes because studies show that saving time reaching those calls tends to save lives.

Other agencies around Inland Southern California will track the new program in Rialto and assess its effectiveness.

The heart of the new system is San Bernardino County’s regional dispatch center, where call-takers have undergone more than 18 months of re-training to enable them to question callers more quickly and thoroughly.

“If you know more accurately what the problem is, you can more accurately assign the proper units,” said Rick Britt, director of the Confire communications center.

And the dispatching happens fast. Based on the new training, dispatchers ask specific questions in a specific order, beginning with the caller’s address and phone number — so if the call gets interrupted, they can still send firefighters or police to the correct location.

Then, the caller is asked the nature of the problem. If it’s a medical situation, the dispatcher immediately sends the nearest available paramedic fire engine.

If the patient’s not breathing, the dispatcher begins offering CPR instructions. Dispatchers also have a list of instructions for callers reporting, for example, suffocations, or attempted suicide-by-hanging.

And for all serious-injury or illness calls, an ambulance or additional fire engines will be dispatched.

“My dispatchers are the true first responders because they stat helping the caller immediately,” said Britt, whose staff serves 12 fire agencies, including San Bernardino County Fire Department and municipal fire departments ranging from Barstow south to Colton and from Redlands west to Rancho Cucamonga.

At least some of those agencies will be studying the results of Rialto’s experiment.

“What I’m picking up from the chiefs is that they’re all interested in it,” Britt said. “They want units available for the serious calls that require them.”

Traditionally, fire departments have sent two paramedic units to each 911 medical-aid call, regardless of how minor the injury or illness. In Rialto, a fire engine and an ambulance were dispatched. In other communities, the mix varies – sometimes two fire engines, or a fire engine and a paramedic squad, for example.

Fratus is confident that the so-called Medical Priority Dispatch System will work. He implemented the same system in San Bernardino, where he previously worked as Deputy Chief. His responsibilities included emergency medical service for that city’s fire department.

By cutting down the number of paramedic units sent to minor incidents in San Bernardino, response times to the most critical medical emergencies improved by roughly 30 percent, he said.

Britt’s dispatchers took the process one step farther, becoming the 169th emergency communications center to obtain full accreditation by the National Academy of Emergency Medical Dispatchers.

“My chiefs wanted us to be accredited before they take the risk in liability and modify the response,” Britt acknowledged. “There is some risk to it.”

By cutting back on the number of units assigned to a call, the door is open to criticism and legal liability, he said. But he believes the risk is minimal to patients and taxpayers. Under the new system, dispatchers have been trained to triage calls, in much the same way newly arrived patients are triaged at a hospital emergency room, he said.

“You only have so many (paramedic) units to put out there,” said Britt, who emphasized that officials simply want to avoid dispatching multiple fire engines to calls where they’re not needed. “In days of shrinking budgets, you can’t afford to do that anymore.”

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