Conversations like these are happening in many communities across the country.
Safe, accurate emergency medical dispatch (EMD) can help preserve crucial first medical response resources for the time-life sensitive calls they can truly make an impact. Tying up first medical response resources on calls they are likely not needed, creates an opportunity for patients with a life-threatening medical condition to receive a delayed response.
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KY City Looks to Cut Non-Emergency Responses
Owensboro fire and city officials said many of the department's 7,600 calls last year were not serious emergencies.
July 17, 2022
https://www.firehouse.com/ems/news/21274362/owensboro-ky-looks-to-cut-nonemergency-responses-for-firefighter
Jul. 16—The Owensboro Fire Department would like to reduce the number of nonemergency medical runs firefighters make.
But Paul Nave, director of Owensboro- Daviess County 911, said dispatch attempts to screen medical calls already, and that the default is to send firefighters when a caller says they have an emergency.
According to the fire department's 2021 annual report, the agency responded to 295 fire calls that year. However, OFD crews responded to 1,596 calls of respiratory distress, 1,024 reports of traumatic injuries and 982 calls of cardiac issues, the report says. Other types of EMS calls include accidents with injuries and falls.
In all, the department made 7,361 emergency medical service runs last year, of all types.
Mayor Tom Watson said firefighters have told him they sometimes go on medical runs that turn out not to be emergency situations.
"There are calls they don't necessarily need to make," Watson said.
City Manager Nate Pagan said talks on the subject at City Hall are preliminary.
City Fire Chief James Howard said responding to medical runs that are not emergencies wears down fire crews.
"Our call volume has gone up and up," Howard said. Calls for service increased by about 12% in 2021, Howard said.
"We have the same number of trucks and personnel," Howard said. "Any time you are doing more work with the same workforce, you have to consider what that is doing to the workforce."
The agency provides basic and advanced life support and makes runs along with AMR, the ambulance service. Howard said OFD is looking at how fire departments in cities such as Bowling Green and Evansville handle medical runs.
The goal, Howard said, is "to make sure we are always going out when we are needed," but the agency would like to find a way to reduce runs to non-emergencies.
"It depends on the reliability of the caller," Howard said. "When we deploy resources, we have to do it in a smart way, that we are (providing) life-saving services when needed."
When there is a medical emergency, "we want to be there and be the first to put hands on the patient," he said.
Nave said the dispatch center "is communicating with Chief Howard on some possible changes to accommodate the reduction in calls." But when a medical emergency call is received by dispatch, "it's not always black and white," he said. "We can only respond to the call based on what the caller tells us."
When a person says they need medical help, dispatch sends the alert to firefighters while taking additional information from the caller.
"Multiple times, the (caller) will say, 'Just send them,' " Nave said. "They don't want to answer questions, and I get that."
Dispatchers will keep talking to the caller, to determine the nature of the emergency, even while responders are already rolling, Nave said.
Regarding firefighters being dispatched on 911 calls that aren't medical emergencies, Nave said, "I understand once they get there it's not always true, but the majority of time it is true.
"I don't want anyone to not call" if they think they have a medical emergency. "If in doubt, you call us."
Dispatch does screen calls to try and determine if there is an emergency, Nave said, and if the criteria isn't met, firefighters aren't punched out.
In April, dispatch did not call out firefighters to 114 calls because they did not meet the criteria for needing OFD responders, according to data from dispatch. There were 135 medical calls that didn't meet the criteria for OFD dispatch in May, and 161 medical calls where city firefighters weren't dispatched in June. Those numbers do not include medical calls OFD is regularly not dispatched to, such as reports of back and abdominal pain, Nave said.
Daviess County Fire Chief Jeremy Smith said the county department made some changes earlier this year to reduce the number of medical runs it makes. For example, the agency no longer responds to calls of threats of suicide, because firefighters would be on standby at the scene while law enforcement works with the person involved, Smith said.
The department does respond to all calls of suicide attempts. Smith said another change limited runs firefighters make to some medical offices, because they are already staffed with medical personnel. But the agency does respond to urgent care centers.
If a medical call does not require advanced life support, volunteer firefighters, who are EMTs, can handle the call without DCFD responding, Smith said. Other exceptions aside, the county department does respond to most medical calls.
"Overall, if the ambulance service dispatch deems it an emergency response, we go," Smith said.
