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October
19, 2010
UPDATE…EMTs
and paramedics are mobile emergency rooms
By CONNIE
LEINBACH
Ocracoke
had more
paramedic-level calls in 2009-2010 than any other type of emergency
call, according to figures released at a special meeting Sept. 22 about
the cost of emergency medical services in Hyde County.
Brian
Carter and Jeff Hibbard, chief paramedics on Ocracoke and the mainland
respectively, made a presentation to the Hyde County commissioners
about Emergency Medical Services.
The
commissioners are trying to determine if and how they can reduce the
$1.5 million budget for EMS services in the county. Expenses
for
the service ballooned to that amount following a law change in 2009
requiring paramedic-level emergency service for the mainland, too.
Before that, the EMS expense budget was $928,672, and paramedics were
only on Ocracoke.
According
to Carter’s figures, Ocracoke had 130 paramedic-level calls that
involved transport to a medical facility, while there were 12
basic-level calls and 9 intermediate level calls.
The
mainland had 183 paramedic calls, 173 intermediate calls, and 160 basic
calls.
Total
calls in both places were: 313 paramedic, 182 intermediate and 172
calls. Of those, 47 percent were paramedic level.
All
told, there were 667 billable calls and 428 non-billable, which means
they were canceled, the patient refused treatment, or there were
fatalities. However, non-billable calls still must be paid for, noted
David M. Smitherman, interim county administrator.
Carter
explained that first-responder and basic emergency medical technicians
can do CPR and cardio-shock. They also get a medical history.
Intermediate-level
EMTs have more diagnostic tools. They can intubate airways, start some
intravenous medications, and give oxygen. They try to determine the
underlying cause of the emergency.
Paramedics
can deliver more drugs and most anything that would be in a hospital
setting.
Then
from Ocracoke, there’s the long trip to a hospital.
“Even
if we get spontaneous resuscitation, we still need to monitor someone
on the way to a hospital,” Carter said. By land, that’s a two-hour
ride. Airlift to the hospital in Greenville is about 35 minutes.
Basic-level
EMTs can administer seven medications and must be proficient in 29
skills. Intermediate EMTs can give 16 medications and must have 36
skills. Paramedics can give 51 medications and must have 59
skills.
“All
(911) calls are potential paramedic calls unless deemed otherwise,” he
said. Peak times for medical emergency calls are between 10 and 11 a.m.
and 2 and 3 p.m. Tuesdays are the peak days for calls.
Cheryl
Ballance, director of the Ocracoke Health Center, in a subsequent
interview, noted that the numbers Carter shared are collected by the
state for each emergency call, which collects the ages of patients,
where they’re from, what skills the responders performed and more.
The
Hyde County EMS system is overseen by Dr. Charles Boyette, the Hyde
County medical director.
Ballance
noted how far the EMS unit on Ocracoke has come since 2004 when
paramedic-level service began on the island.
“This
began as a group of volunteers and now they have uniforms and training
and they’re very professional.”
The
Ocracoke Health Center is a family practice business and is not
equipped to respond to emergencies, such as heart attacks, shark
attacks, drownings or fractures.
(Cheryl
Bierlein is also a reporter for The Observer in Ocracoke.)
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