The Santa Barbara County Board of Supervisors unanimously decided recently to have two ambulance providers to serve the county, American Medical Response (AMR), and the County Fire Department.

Putting this political decision in to operation could become complicated and expensive.

Lately, there has been a disturbing trend for some elected officials and private citizens to think that they are better prepared to address Emergency Medical Service (EMS) management than the professionals in government.

In this case, it appears the Board of Supervisors may have ignored the input from the experts they hired to evaluate the responses to their request for proposals to provide EMS. These experts concluded that AMR was most responsive to the solicitation.

Perhaps the supervisors may have considered the slow response times for AMR and/or availability of units during peak periods when making this decision. But maybe they didn’t include those types of metrics in the RFP.

First a little history. Until the mid 1970s few fire departments provided EMS care and even fewer provided ambulance service. While fire departments always provided physical rescue capability, transportation of the injured was left up to private services.

In many cases this service was primitive when compared to today’s efforts and no advanced care capability was available on scene or en route to the hospital.

In the mid 1970s fire departments in most major population centers began providing advanced on-scene medical care to heart attack and trauma victims and this experience paved the way for the current response and crew training protocols.

These policies have saved many people suffering from cardiac arrest and other critical injuries.

The primary reason for fire departments to start responding to medical calls was that typically a fire engine, with a properly trained crew, could arrive and begin providing emergency medical treatment before ambulance companies could.

Considering there are far fewer ambulances in the county than fire crews, this is still a valid justification.

Four trained responders are required to properly provide care during a cardiac arrest, plus supervision. Keep in mind that during a heart attack the care provided in the first six to eight minutes from the onset of the event is critical for a positive outcome.

The Lompoc Fire Department does not provide transportation; however, all firefighters are qualified emergency medical technicians and can begin treatment when they arrive on-scene.

The Santa Barbara County Fire Department currently operates three rescue ambulances: one at UCSB, one in New Cuyama, and the other in the Lompoc Valley unincorporated area.

AMR provides ambulance service in all areas of the county except New Cuyama, and they respond to tens of thousands of calls annually.

The focus of all fire departments has always been on the people they serve receiving prompt attention and care, and doing the best for those who need help.

For the week ending Aug. 25, Lompoc Fire Department reports it responded to 73 EMS calls: that’s more than 10 each day.

In most cases AMR provided ambulance service, but a County Fire Department ambulance also required for many of those calls because AMR was not available.

Will the current BOS plan to provide adequate and prompt emergency medical transportation services work? Will it improve response times?

No one will really know until the plan is implemented, and if it doesn’t work it may be too late for people who rely on the service.

Noozhawk reported on July 19: “Since the County Fire Department plans to apply for a permit to provide ambulance services starting next year, the county needs to establish job classifications for ambulance operator employees.”

And on July 25: “As of now, 35 ambulances have been purchased and delivered.” Looks a lot like a decision has already been made.

Not mentioned is the future cost for County Fire to provide ambulance services. If all 35 ambulances were staffed it would take a minimum of 210 new firefighters (two per unit/three shifts), plus overtime for those who are on vacation, injured or out for training. And you must add the future costs to the retirement fund.

One thing is certain, firefighters and AMR are an integral part of the patient care experience and can provide myriad functions at even the simplest call by providing rapid assessment, collecting vital signs, initiating treatment, and providing patient updates.

These skilled providers always work in conjunction with each other to deliver aid to those in need.

The dedication of service by both the Fire Department and AMR crews won’t change, but the cost for two service providers may.

References:
https://www.noozhawk.com/santa-barbara-county-supervisors-approve-ambulance-operator-job/