Bolton: EMS, fire consolidation effort an emergency

Associate EditorOctober 11, 2009 

DURING A recent visit with my brother Eugene, a trauma nurse in Jacksonville, Fla., I mentioned that, back home, authorities were trying to determine whether the lack of coordination between firefighters and EMS workers contributed to the death of a young boy in Richland County.

He had the most befuddled look on his face as I told him that although firefighters and two EMS workers were on the scene, the 3-year-old couldn't be transported until a second ambulance arrived. County policy doesn't allow firefighters to drive ambulances - even in dire emergencies.

"What do you mean?" he asked. He had more questions, many of which I couldn't answer. I had taken that Sunday's State along and we both read the story by staff writer Adam Beam.

We discussed the case a couple of times during my too-brief stay in Jacksonville and ended up scratching our heads each time. Why would there be a policy that would work against the best interest of patients?

It's a question Richland County and Columbia need to answer in short order.

As it stands, citizens who call 911 when a family member falls critically ill are left to wonder if they'll have to wait for a second ambulance as precious, life-saving minutes pass. We've learned that the four-minute delay in the case of Jadan Myers-Pugh wouldn't have mattered. The Richland coroner says the boy already was dead - stricken by the swine flu.

But while the 911 call didn't help Jadan - and I pray for God's peace and comfort for his family - it has turned into a distress call for all of Richland County. Had what transpired not happened, there' s no telling when - or if - sufficient light would have been shed on this pathetic policy.

It seems momentum is building that could lead to a change that would allow firefighters to be trained and authorized to drive ambulances. That ought to happen right away. Who knows how soon the need will arise?

But that change would only be a step toward what ultimately needs to happen. The city and county should merge these departments that interact regularly in pressure-packed, life-threatening situations. If they're operating as one, they'll be on the same page and, likely, more efficient and proficient when it comes to saving lives.

In truth, merging fire and EMS is the real emergency here.

As I talked to my brother, I understood why he looked so befuddled and had so many questions. In Jacksonville - as well as other cities - coordination between EMS workers and firefighters is like breathing.

Not only are the fire and EMS departments not part of separate governments, they aren't even separate departments. No competing agencies out to protect their domain. Just the Jacksonville Fire and Rescue Department.

I went to the department's Web site and found some interesting history about the marriage between fire and EMS.

In 1962, the Jacksonville Fire Department's assistant fire chief argued that the city should stop relying on funeral homes' hearses to provide ambulance service, saying that they placed more emphasis on - you guessed it - having funerals than transporting the sick and injured to the hospital. (In days gone by, funeral homes provided ambulance services in many communities across the country, including here in the Midlands.)

In late 1967, then Jacksonville Mayor Hans Tanzler ordered emergency ambulance service to be permanently placed under the fire department. It took a while for the service to become modernized. The department's Web site notes that crews realized "they were in over their heads due to the nature of the calls, a large proportion of which were cardiac related, so the department connected with area doctors eager to provide better training. With advanced medical training and better equipment, the Jacksonville Fire Department saved more lives, and Jacksonville became known as the 'safest city in the world to have a heart attack.'"

Columbia and Richland County, which have had hot and cold moments when it comes to consolidating services, could learn from what happened in Jacksonville in 1968.

That's the year Jacksonville and Duval County governments consolidated. Today, the Jacksonville Fire and Rescue Department provides fire and emergency medical services to an area of 840 square miles with a population of more than 850,000.

It doesn't matter where the emergency or fire is - the city, the suburbs or the rural areas - the Jacksonville Fire and Rescue Department responds. It sends a fire engine and rescue unit on every EMS call; all firefighters are emergency medical technicians. Thirty fire engines are outfitted with advanced life support equipment; at least one paramedic is assigned to each unit.

It took some cooperation and coordination for Jacksonville to get where it is.

A consolidated Columbia and Richland County would be the answer for many of the common problems the city and county face. Politically, that's a nonstarter right now. But the two governments should consolidate as many services as possible, in the best interest of citizens and taxpayers. While there are savings to be had in some instances, in others, it just makes practical sense and could lead to better service.

There's no good reason for fire and EMS to be separate. If there is, I'd like to hear it. Even if there is a legitimate reason, it would fall second to the main stumbling block: Some city and county officials see protecting their power and turf as job one.

But the 911 call has gone out. Lives are potentially hanging in the balance. The status quo just won't do going forward.

Reach Mr. Bolton at (803) 771-8631 or wbolton@thestate.com.

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