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Changing rules for emergency response

 

“…dedicated to the best possible response to all emergency calls in the city of Clarksville. We strive to provide top-flight customer service to all aspects of our mission through our fire suppression activities, medical assist responses, daily and annual training, fire prevention inspections and public fire education programs, fire investigations, safety practices, and vehicle maintenance procedures.”

— Clarksville Fire Rescue

Debra had allergies. To everything. The list of foods she could eat was a single page. Two brief columns of edibles that would not kill her. She carried a stash of epi-pens — in the kitchen, in the bedroom, in the car. Her reactions happened fast. Shortness of breath, then unconsciousness. On one hair-rising night, a night when I just stopped by for a moment and found her door open, her beloved house cats loose in the hall and her body on the floor gasping for air, though I didn’t know she was a step away from death. I jabbed her with an epi-pen even as I dialed 9-1-1, which dispatched a crew from a point just a minute away. Four days later Debra was released from the hospital, until her next crisis. According to reports, her conditions were “allergic reaction” and “shortness of breath.” According to the Emergency Room doctors, she was lucky to have survived at all.

Who says shortness of breath or an allergic reaction are not a medical emergency worthy of the fastest response, including response by Clarksville Fire and Rescue? Or that it can wait for a county service to respond? The rapid response of a neighborhood fire and rescue team saved Debra’s life more than once.

Strokes can paralyze, kill, and result in brain damage; early response to and treatment for stroke is critical. Minutes make a difference.

Chest pain, shortness of breath and even what seems like indigestion can also be the symptoms of a killing heart attack; there are no hard and fast rules on how long it takes for the symptoms to manifest full scale cardiac arrest.

Where does a diabetic crisis fit into these new parameters?

The Clarksville Fire Rescue mission statement includes the words “all emergency calls” and the words “medical assist.”

Although Clarksville Fire and Rescue has ten locations across the city and has been considered the first line of contact in an emergency, new rules will now prohibit CFR from responding to calls for difficulty breathing, chest pain, asthma attacks, strokes, allergic reactions, and overdoses. Instead, those calls will be responded to by Montgomery County Emergency Medical Service stations, which has nine locations and are now the designated responders for “medical calls.” Some EMS stations actually share facilities with CFR. And CFR will still respond to cardiac arrest, amputations, choking, childbirth/complication, chest trauma, and heatstroke.

If your heart has stopped you get CFR; if it’s still beating you wait for EMS. If you are choking you get CFR; if you are having trouble breathing you wait for EMS. Either way you’re in big trouble, either way you may suffer devastating consequences, all because of definitions. It’s a line item veto for emergency health care.

Because of the EMS “medical response” designation, CFR will not automatically answer calls for issues such as breathing difficulty, asthma attacks, allergic reactions, chest pain, stroke and overdoses, despite the fact that all of these conditions can quickly become life threatening.

Tell that to someone whose non-critical condition turns catastrophic. That can and does happen in an instant. It makes sense that, in the interest of public safety, the nearest available trained crews should respond. It is a matter of life and death. Do you want to wait for EMS when CFR is around the corner? Is CFR needed if EMS is two blocks away?

Montgomery County EMS is currently building a new base close to the new Gateway Medical Center, a move calculated to better serve the burgeoning population in that part of the city, as well as the county-wide services they provide. That’s fine, and we applaud the services all CFR and EMS staff provide; they are the front lines in crisis response.

But Clarksville itself is huge, and its citizens, regardless of which district of the city they reside in, regardless of their step on the economic ladder, deserve the best and the FASTEST response to any medical emergency that arises, whether it is from CFR or EMS. Of the 6500 calls CFR responded to last year, 3100 were medical calls. How many of those call would now shift to EMS?

To do less is a disservice to the people of this city.

Clarksville Fire Rescue

199 people assigned to ten bases around the city:

  • Fire Station 1: 802 Main Street
  • Fire station 2: 580 Fire Station Road
  • Fire Station 3: 112 Maxwell Drive
  • Fire Station 4: 1550 New Ashland City Road
  • Fire Station 5: 111 Stephanie Drive
  • Fire Station 6: 8 Ashbuty Road
  • Fire Station 7: 199 Airport Road
  • Fire Station 8: 190 East Old Trenton Road
  • Fire Station 9: 200 Holiday Road
  • Fire Station 10: 1591 Needmore Road

Montgomery County EMS

110 people at nine bases around the city:

  • Administrative headquarters: 1608 Haynes St.
  • Station 20: 1610 Haynes St.
  • Station 21: 1133 Peachers Mill Rd.
  • Station 22: 321 Warfield Boulevard
  • Station 23: 385 Highway 149 (across from Fred’s)
  • Station 24: 2274 Dover RD Woodlawn, TN @ Woodlawn Fire Department
  • Station 25: 820 Fire Station Road
  • Station 26: 2633 Tiny Town Road at Hazelwood Elementary School
  • Station 27: 3991 Morgan Circle Road near MCHS
  • Station 28: 2 New Providence Bvld. at base of Boot Hill
  • Station 29: 3850 Guthrie Highway (under development)

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6 Responses to “Changing rules for emergency response”

  1. Armyparamedic Says:
    October 24th, 2007 at 7:14 pm

    We have to remember that the 9 EMS stations cover the whole county and at any given time, move trucks to cover other zones during peak time in the past few months there was only one EMS unit not on a call. Station 20 has two units every day with at time has up to 4 units during the day,then 2 at night, all other stations at least one, station 21 sometimes has two units

  2. MedicBinky Says:
    October 24th, 2007 at 7:15 pm

    Where do I begin? I’m not sure if it was intentional to imply that the citizens of Clarksville routinely “wait for EMS”. The fact of the matter is that MCEMS averages a less than 5 minute response time. News channel 5 recently had a story naming MCEMS as one of the lowest response times in Middle TN. Citizens “waiting” for EMS is not the issue. The bigger issue is that, for years, MCEMS has not only trained first responders at CFR, we have also provided basic supplies for their rescue trucks. What does that mean? It means that it costs the city NOTHING but fuel to respond to medical calls! EMS has always provided the oxygen and whatever supplies CFR asked for.

    The only time that someone is forced to “wait for EMS” is when the ambulance responsible for that area is already in service on another emergency. Usually EMS tries to keep this from happening by pulling units from “slower” zones to the edge of their zone to assist in coverage.

    Also, please note that of the medical emergencies CFR responded to, EMS responded to them as well. We have reached over 24,000 calls this year. We are stretched very thin at times but manage quite well with the personnel we have. EMS also responds to EVERY structure fire. We routinely respond to assist CPD and MCSO with serving high risk warrants. We also have the Emergency Response Team that responds to swift water, high angle, and dive-type rescues.

    EMS’s call volume is more than 20 times what CFR’s is. We have less people and cover a greater area. In short, we do what we can when we can. EMS has NEVER held any negative feelings towards members of CFR and appreciate every effort they have made to help us. IT IS NOT EMS’S POLICY that is in question. This change in response protocol came down from CFR management not EMS’s.

    Finally, let me say that EMS personel and CFR personel have more than professional relationships. I call many of the employees from both departments friend. I choose to spend my days off with many members of both departments. Most of the feedback I get from CFR employees is that they are as confused about this decision as we are. They, too, are struggling to understand it. Maybe they speak out less because they are afraid of some kind of retalliation from their management! BBest…EMT-P

  3. Bill Larson Says:
    October 24th, 2007 at 8:35 pm
    Bill Larson

    Nothing in the article should be taken as criticism of the fine job done by the men and women of the Clarksville Fire department or the Montgomery County EMS. We have nothing but respect for the professionals that staff those organizations.

    Our issue is that when there is a medical emergency the closest organization with available units should respond, minutes matter! We should not allow our first responders hands to be tied up in a bureaucratic squabble between the city and county. The public should demand nothing less.

    I personally spoke with the Montgomery County EMS today, and I got the impression that they felt that we were hitting the point right on the head with our article.

  4. Fire Friendly Says:
    October 29th, 2007 at 10:50 pm

    Medic Binky: you sure know a lot about CFR. Where did you get your info?

    I would dare you or this service to check the records of CFR (firehouse) to see how many medical runs have been made since this so-called change was made.

    I would also challenge Clarksville Online to call the fire chief and ask him if and when he or any of his staff sent any correspondence to e-911 director to make any changes to dispatch of any CFR units for medical calls.

    I anxiously await your next post with corrected information.

    Please get your facts straight from the horses mouth (Chief Roberts) of CFR before you scare people into thinking CFR will ever let them down.

    The city administration has invested and continues to invest in quality fire and medical capabilities to always serve all of our loved ones, both yours and the stranger passing thru our beautiful city. Keep up the good work CFR & MCEMS. The next life you save might be mine.

  5. MedicBinky Says:
    October 30th, 2007 at 4:36 pm

    Fire Friendly,
    You are correct. I do know alot about CFR. Some of the info you are questioning I have received from various memos. We (EMS) received a memo stating that it was CFR’s decision not to respond to anything but the things listed in the article above. That is a fact, not speculation. I have a copy of it, if you would like to read it.

    As far as the supplies we provide, I have personally, on numerous occasions, replaced empty O2 bottles and given items such as gloves to CFR EMC’s. (CFR first responders) Who do you think pays to have O2 bottles refilled? Another fact.

    I’m not sure on what points you think I am mistaken. Our (EMS) memo clearly stated that per CFR WE were to no longer use CFR for things not on the list. I would not have stated what I did if I wasn’t 100% sure of my accuracy. The only thing that may be exagerated is that we probably only make 10 times the calls CFR does.

    By the way, I hear a memo showed up at dispatch last night changing things back to the way they were. Hmmmmm…

    I have never stated that CFR would let anyone down. If you reread my response, 99% of it is in defense of EMS. NOT an attack on CFR! I have nothing but love and respect for members of CFR.

    As far as your account of how many medical calls CFR ran during that time frame, I do not know. But isn’t that their job? BBest EMT-P (not afraid to put my name)

  6. Fire Friendly Says:
    October 30th, 2007 at 9:03 pm

    BBest: I checked and what your last post said is TRUE. I have not seen the memo you refer to,was it sent to EMS or CFR? I have seen the priority 1 and priority 2 list and was told by an officer at CFR that all P1 calls were on the list of automatic responses for EMS & CFR. If you have a copy of any Memo with the Fire Chief or Deputy Fire Chief signatures on it concerning any change in responses, I would like to have a copy of it. I was assured this has never happened! Bottom line….I have visited CFR stations and listened to call after call when EMS failed to timely notify CFR of not being needed.
    while I don’t know you. I do know there are persons at EMS who have abused CFR personnel responses to do their work (Lifting)Etc. I hope this can be worked out between all the players (management sets the order of things) 911,EMS,CFR so that harmony will prevail and City & County taxpayers will receive the service they deserve.

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