The comfort of seeing an ambulance staffed with trained medical personnel at Lexington County high school football games does not come without a price.
For the second season in a row, the county's Emergency Medical Service will not place ambulances at games, and Lexington County schools must now pay if they want a similar service.
That differs from Richland County, where county-owned ambulances are provided for every public school game at no charge.
That makes Lower Richland athletics director Robin Bacon glad to be employed in a Richland school district.
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"It's great," Bacon said, "because obviously, with any kind of heat-related illness or a spine or neck injury, time is of the essence to get to the hospital."
To get that level of medical attention, Bacon's Lexington County counterparts must pay for a private ambulance service or call 911.
Half of the county's 10 high schools (Pelion, Gilbert, White Knoll, Chapin and Irmo) hired private ambulances at costs ranging from $130 to $250 per game. Another, Batesburg-Leesville, has EMTs among its community that donate their time to staff an ambulance at middle school, junior varsity and high school games.
Four schools, Airport, Swansea, Lexington and Brookland-Cayce, have athletic trainers and/or doctors on their sidelines. But they must call 911 to receive ambulance service.
"We have a trainer there to help diagnose," Swansea athletics director Bucky Stroud said, "and then we call 911."
That process led to a delay of around 35 minutes during an on-field injury at Airport's Sept. 25 home game against Battery Creek. Airport trainer Katie Moore said her staff treated the injured player, and an ambulance was called as a precaution.
Brian Hood, Lexington County EMS coordinator, said two factors led to the policy change that took effect in 2008.
First, the county switched from 24-hour to 12-hour shifts for EMS workers. With shifts beginning and ending at 7 p.m., just before the 7:30 p.m. kickoff times, Hood said it would take until halftime or later for the crew to be in place after mandatory new shift procedures are completed.
Secondly, an increased annual number of service calls made him think the units were better employed elsewhere.
"As the call volume has continued to increase, along with shift change, there were fewer and fewer times that we were available to standby at games," Hood said. "The ambulances would have to weave through the parking lot to go on calls. It became rather cumbersome."
When he decided against paying for a private service to staff Swansea's varsity games at Doug Bennett Stadium, Stroud weighed the fact that Lexington County ambulances frequently left the game early for other calls.
"If they got a call, they had to leave immediately," he said. "We never had one here after the first quarter. It's the nature of the beast. They had to go where they were needed. It's not that big of a change for us."
Others, like Chapin High head athletics trainer Fred Williams, said the number of people concentrated in that one place justify having an ambulance on site.
"When you have a high school football game," Williams said, "there are a huge number of people there in one location, and most pay taxes in that area. It seems like they would be able to provide coverage for us. At the same time, Lexington County is large, and with five (school) districts, they are stretched thin."
Richland County EMS officials side with Williams.
"We of course look at it as a priority," Richland County spokeswoman Stephany Snowden said. "But it's not just football. We cover large youth soccer tournaments and large festivals, such as the Sparkleberry Fair. We just know that wherever large numbers are congregating, the chances of some sort of medical emergency increases exponentially."
Richland County's ambulances sit on standby at all public high school varsity games, but they sometimes leave to answer nearby calls. The county does not charge the schools. If private schools request an ambulance at games, the county charges for overtime, which Snowden said is between $100-$150 per game.
Back in Lexington County, Irmo High athletics director and football coach Bob Hanna estimated his budget took a $2,000 hit for private ambulances to cover his school's eight varsity home games last season.
Hanna doesn't blanche at the dollar cost, because he said the human toll would be worse.
"We've got to have them here," Hanna said. "A cost is a cost. But it would cost a lot more if someone got hurt badly and they weren't here."