From time to time, a discussion will arise about whether people are better served by a membership-based ambulance service manned with all volunteers or an ambulance district paid with tax dollars and a paid crew.
This time the discussion is being led by the North Fork Ambulance Association itself. The reason is there a fewer citizens wanting to volunteer their time.
Dr. Peter Pruett is the physician adviser, or medical director as the state calls him, for the North Fork Ambulance Association. He is a staff emergency room physician for Delta County Memorial Hospital. He is involved in training the EMTs through call reviews, where they go over the interesting and challenging cases transported in the previous months. Dr. Pruett does the call reviews about every two months, as well as specific topic training sessions requested by the EMTs. Those sessions happen about three times a year. He is the liaison between the hospital emergency department and the EMTs.
Dr. Pruett’s background is in emergency medicine. His medical degree is from the University of Colorado. He trained at Denver General Hospital to be an emergency physician. Subsequent to that he was a staff emergency physician at the level two trauma center at a hospital in Aurora for 15 years. He has worked with many paramedics and taught classes for them.
Pruett has worked in the Delta County Emergency Department for about four years — two years part-time and two years full-time. Dr. Dory Funk asked him about taking over as physician advisor for the North Fork Ambulance Service.
He recently shared his observations of the differences between an urban taxpayer-based medical system and the North Fork’s volunteer ambulance service.
“I hadn’t run an emergency medical system before, but I have been impressed with the quality of care the North Fork Ambulance EMTs were giving to the patients they brought to the ER from the North Fork where I live. I thought it would be fun to get more acquainted with them as people and with them as volunteers who provide pre-hospital emergency care. I began that role as a volunteer medical director for that group,” he explained.
Pruett works specifically with the North Fork Ambulance crew. They operate under his state medical license. A licensed medical doctor must provide training and guidance for the medical care given to patients in the pre-hospital arena.
The volunteers in the North Fork are Basic EMTs. There are five or six intermediate EMTs which can give a higher level of care with medication and some advance procedures. “They do their Basic EMT job extraordinarily well. A difference I see is that the volunteers give a lot more care and respect for their patients than I commonly saw in urban paramedics who frankly would often become quite burnt out by the volume of their work and the harshness of the situations they were dealing with. So, our Basic EMTs in the North Fork are giving a lot more special attention and care to the people they transport. They transport people much farther and the patients are under their care for a much longer period of time than in a metropolitan center.”
Pruett said the transport time from Paonia to the hospital is 30 minutes, maybe 20 from Hotchkiss, and perhaps 30 from Crawford. There are also many patients in the outlying areas, including in the mountains. “It can be a very lengthy transport and also involve extrication of the patient from a dangerous situation,” Pruett shared. “That’s completely different from the metropolitan area. [The North Fork EMTs] are very experienced. They are very proud to solve unusual problems in the field. I think they are quite good at it. I think it would be almost impossible to replicate that kind of expertise and care by a small municipal system here. I just don’t think it could be done.”
The North Fork Ambulance Association averages about two runs a day. Dr. Pruett said that number of runs could not pay for a small municipal taxpayer-based ambulance district. “It would be difficult to have an efficient EMT system because the EMTs would be spending so much time waiting for calls,” Dr. Pruett shared. “A volunteer system is so much more efficient here because people can go on with their regular jobs. When a call comes in, they can respond. If you had to pay EMTs to sit and wait for the two calls a day, or no calls and then four calls a day later, it’s going to be inefficient and expensive as a way to do it.”
If there were multiple calls it would be difficult to serve patients in the North Fork district with just a paid crew of two people. There would still be a need for volunteers to serve as back ups or another ambulance service would have to be called. Dr. Pruett believes patients could be left suffering while waiting for someone to respond. “I’m really impressed with what the EMTs do here and how efficient it is for providing emergency care and transporting.”
Who would be a good candidate to volunteer for the ambulance service? “We certainly want volunteers to be healthy. It does require someone to be active. Lifting is often something that can be assisted by other people. The sheriff’s department is usually on the scene and the ambulance driver. So you don’t have to be terrifically strong, but healthy. You don’t have to have any medical background. The Basic EMT training is mostly common sense and a little bit of practice at utilizing the basic equipment we have on our ambulances. You don’t really need to have or to learn knowledge of medications or advanced procedures. It’s basically stabilizing someone, getting a history of what happened and communicating your situation to the emergency department while you are in route. I can’t pretend it won’t take some time to go through the Basic EMT training, but that is provided in Paonia,” he said. Basic EMT training is given at the Delta-Montrose Technical College in Paonia and Delta.
“You meet a lot of interesting people who are lively and interested in being a part of their community. I think the training has been a lot of fun to go through. The amount of time is really up to the volunteer. You can do one or two days a month if you want to. The chances are you will have one or two runs in that period of time. If you want to do more, you certainly can do more shifts. If you are having fun doing it, you can do as much as you want. Even doing a couple of days a month is a wonderful service to the community. You get to know your community in a way you haven’t before. For most people there is a tremendous sense of satisfaction from really helping people who are in dire need. What I’m looking for, is just someone who is willing to get involved in learning how to provide basic medical care and pay attention to what the situation is and just provide good common sense care between the scene of the accident or home and the emergency department.”
If the North Fork Ambulance Association is truly unable to provide enough volunteers to get that job done, Dr. Pruett suspects it would be expensive and quite inefficient to go to a taxpayer-based district that could only afford a crew of two EMTs. “I can’t imagine how it could be any better than what we have right now,” Dr. Pruett responded. “I think the North Fork is very fortunate to have a group of volunteers as dedicated and enthusiastic as the North Fork Ambulance Association. I don’t think a lot of community members know how much time some of them put into this organization for free. I think it is easy to pick up the phone and call 911 and assume that everything will happen the way it happens on television. A qualified group of EMTs show up in a few minutes, and currently that is happening. But that may not necessarily continue to happen if we don’t have community members volunteer their time to help out. It’s a very fun group of people. Even though they take care of people who are quite sick and injured at times and they take their jobs quite seriously, there are also a lot of great stories and a lot of camaraderie. If you are going to volunteer in your community, this has got to be one of the most fun ways you can do it.”
If you would like to learn more about becoming a Basic EMT or a driver for the North Fork Ambulance Association, call their office at 872-4303.
