Policy nudges out volunteers

Published 5:33 pm Saturday, April 11, 2015

The Nansemond-Suffolk Volunteer Rescue Squad hasn’t responded to a single call since March 8, the day before Suffolk Fire and Rescue started cracking down on a policy it says has been in force for years.

Rusty Hundley, a member of the squad’s board of trustees, says the policy requires the driver of an ambulance to be certified at least as an EMT-Enhanced. It’s the second-lowest level in a four-tier system of certifying emergency medical providers in Virginia.

The title of EMT-Enhanced has been discontinued and is being phased out and replaced, but the current certifications are still good for the individual medics until they expire.

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“EMT-Enhanced was never an issue until March 9,” Hundley said.

That’s the day when the volunteer crew that went on duty that evening — with a paramedic (the highest certification in the four-tier system) and two EMT-Basic (the lowest in the system) on board — was told it couldn’t run calls.

Even so, the crew waited. Because of a policy instituted in 2013, the squad runs calls only after all other ambulances that could respond to it are busy.

That evening, at 7:38 p.m., a car hit a pedestrian on Finney Avenue. Because the volunteers weren’t permitted to respond, an ambulance from the White Marsh Road station responded — and was delayed by a train.

At 7:53 p.m., a 1-year-old fell and injured his or her head on Wellons Street. Again, the volunteers were not permitted to respond. An ambulance was sent from Kings Fork Road — about a 10- to 12-minute drive away.

After a similar situation during a third call, the crew ended its shift at 10:30 p.m. that night. Later that week, an ambulance from the Holland station — about 18 minutes away — responded to a sprained ankle call that the volunteers could see from their Market Street station.

“Somebody needs to explain to me how that improves patient care in our community,” Hundley said. Since the volunteers know their time away from home will be wasted, they haven’t been showing up for shifts, he added.

“Unless we want to dilute our resources and put two paramedics on a truck, we cannot run,” Hundley said.

He stressed that the issue isn’t with the fire and rescue department’s personnel.

“The fire department personnel are good, dedicated people,” he said. “The medics provide excellent care, and we are proud to work with them. The issue is the policy.”

But Fire and Rescue Chief Cedric Scott sees things differently.

The issue isn’t who is actually driving the ambulance, Scott said. It’s about having two people who can provide care to a patient when they arrive on scene.

Someone certified as EMT-Basic, he explained, isn’t certified to perform as many tasks as an EMT-Enhanced and therefore cannot be much help to the higher-level provider on the scene.

“We are looking at the standpoint of providing two health care providers to assist the patient,” he said. “If you have two people on an ambulance delivering care, that provides the (Advanced Life Support) provider an opportunity to focus more on the signs and symptoms the patient is delivering. If you have two people who are knowledgeable, the ALS provider does not have to do every single thing involved in the care of the patient.”

For example, Scott continued, “You could be helping me, so I don’t have to set up the cardiac monitor, then I go to the IV, then I go to the medication. That contributes to the care the patient is receiving versus having only one person back there.”

Scott said the state does allow an EMT-Basic certified individual to be the only other person with someone of a higher certification.

“What they’re requesting to do or wanting to do is acceptable in the state,” he said. “But we operate above that standard. We are simply providing someone in need of our services two health care providers.”

The policy has been in force for many years, Scott said, and only recently is being enforced on the volunteer rescue squad because the squad’s noncompliance was recently discovered.

“I am certainly not happy that Nansemond-Suffolk is affected by this,” Scott said. “That does not bring me any joy. I want to see them be a part of delivering emergency medical services in the city. I just hope we can work together to continue the discussion and do what we can.”