“In my opinion, this is government at its worst.” Greg Sanders, President CCSD
The facts are these:
in 2006, the CCSD and CCHD entered into an agreement whereby the portable ALS equipment was available to be on the Fire Truck for use by the qualified paramedics who arrived at a scene, to aid in the life-saving activity.
The faster emergency personnel arrive on the scene, the better your chances of survival and complete recovery. Chief Miller ventured a guess that about 75% of the time, (and probably more) the fire department arrives first.
The ambulance arrives anywhere from 1 to 5 or more minutes later. Those minutes could mean all the difference.
Currently, every firefighter is also a certified EMT trained and certified to use the ALS equipment. In fact, nearly every one also works part time at the Heathcare District. When they arrive on the ambulance, they are allowed to perform any needed treatment, including the ALS. If that same person arrives on the fire truck, even if they arrive first, can not render aid.
One big hint that this issue is important was this: An ALS that would stay on the fire truck would cost $20,000. District policy allows expenditures up to $25,000 without Board approval. There are regular expenditures that just barely meet the criteria of under $25,000. So why did this come to the Board? Because they could buy the equipment, but the CCHD must authorize its use, something it doesn’t seem willing to do.
If you’ve got 20 minutes, watch this part of the February meeting. If you don’t have 20, fast forward and watch the last 5 minute (start at 15:00) for a summary of Muril’s position.
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You have your facts wrong, currently only 4 of the aprox. 18 firefighters are paramedics and can use the ALS equipment. All the rest are certified at the EMT level. The ALS equipment can only be used by paramedics which are on duty roughly 1/2 the time. The equip. would then be placed on the engine when a paramedic is on duty. The fire dept. should have this gear, and we should also look into placing paramedics on the fire engine 24/7.
Thanks for the correction, Glen. AboutCambria.com works hard to make sure we get our facts straight, but sometimes we miss something.
There are some inaccuracies in your THE TIP OF THE ICEBURG IN EMS IN CAMBRIA STORY that I would like to share with you:
Paragraph #1. On July 20, 2007 the County Health Officer, approved a request by Don Melendy to allow Healthcare District personnel on duty with the CCSD Fire Department to carry ALS equipment and supplies on a permanent basis.
Because the CCHD is the licensed agency to provide advanced life support (ALS) on the north coast, any paramedic employed by the CCSD Fire Departmenrt must also be an employee of CCHD in order to perform ALS services while on duty as a firefighter.
Paragraph #2. Chief Miller stated that he believed that fire agencies may arrive at the scene before the CCHD ambulance around 75% of the time. Both Cambria Fire and Cal Fire are dispatched to all code-3 medical aid calls within the CCSD boundaries. The protocol is based on the fasted medical aid/fire intervention. Frequently, the medical aid location is closer to one or the other fire stations.
Paragraph #3. I don’t believe that anyone stated the ambulance arrives 1 to 5 minutes later. The point Chief Miller made was that in the case of cardiac arrest the guidelines are that advanced life support (whether delivered by an ambulance or fire engine medics) should initiate care within 4-minutes 90% of the time for the outcome to have a chance at being successful. So yes, every minute counts. When Cambria Fire was allowed to carry and use ALS equipment and supplies, and if they arrived at a scene before the ambulance, they would initiate ALS intervention if the their paramedic deemed it necessary. For example, cardiac monitoring is an ALS skill, at the present time, the firefighter paramedic can only perform at an EMT level until the CCHD paramedics arrive.
Paragraph #4. Every firefighter is a certified Emergency Medical Technician (EMT) but is NOT CERTIFIED TO USE ALS EQUIPMENT. Chief Miller stated that four paramedics work for both the CCSD Fire Department and CCHD. Some are full-time firefighters and work part time on the ambulance and some are full time ambulance paramedics working as a paid-call reserve for the fire department. This paragraph goes on to say that when a paramedic employed by CCHD arrives at a scene they can initiate ALS care. This is correct. It goes on to say that when this same person is working for the CCSD Fire Department and they arrive at a scene (in a fire engine) they cannot render aid. This should say that they can not use their ALS paramedic skills but they will render EMT-level aid to the patient.
Paragraph #5. There is a cost estimate of $20,000 to purchase all necessary ALS SUPPLIES and EQUIPMENT allowing fire department paramedics to provide ALS service. If CCHD would not allow CCSD Fire Department to use their ALS equipment, the thought was that CCSD would purchase their own gear. Makes sense.
Cambria Fire is researching this however, when providing ALS services, they are operating under the license of the Healthcare District and UNTIL an agreement is worked out to allow Cambria Fire to operate a paramedic engine company (only when a paramedic is on duty, which is not 100% of the time at present), it would not make sense to spend the money if the gear cannot be put into service. The CCHD will not allow the fire department to act as an ALS provider under their license at this time, even if CCSD purchases ALS equipment and supplies.
THE HEADLINE SHOULD READ, “MURIL CLIFT STATED THAT THE MAJORITY OF THE CCHD BOARD MEMBERS HAVE PUT THE LIVES OF THIS COMMUNITY AT RISK.”
The goal of our EMS system is to have rapid ALS intervention for cardiac care and other life threatening emergencies. The goal of arrival within 4-minutes of receiving the dispatch and initiating ALS care SAVES LIVES. It doesn’t matter which agency arrives first with ALS capabilities but the first arriving paramedics should be able to initiate ALS protocols if needed. Chief Miller stated that often a fire agency is first to arrive, so it makes sense that Cambria Fire should be allowed to provide ALS services when there are paramedics on duty with the fire department.
Allegedly, CCHD feels that there may be a liability issue and have been “looking into this” for a long time. Muril, an insurance company executive, says one phone call to their insurance agency would answer the question and then a plan could be made to allow Cambria Fire to perform under the license of CCHD in offering ALS service to the community.
Muril believes, and I agree, that the majority of the CCHD Board feel threatened because if the cooperative ALS program is successful in providing a hgher level of care for the people of the area, then their little kingdom may be absorbed (consolidated with) by the Cambria Fire Department or Cal Fire. Muril goes on to say that he has utter contempt for the majority of the board for their self-serving attitude. They have put the lives of the community at risk by not allowing CCSD Fire to provide ALS services when qualified personnel are on duty. This reduction in service could COST YOU YOUR LIFE.
I URGE ALL CITIZENS OF CAMBRIA TO CONTACT THE CCHD Administrator, Don Melendy, and ask him to explain the Board’s and his position on this matter.
Michael Walsh
Interesting infromation but I had no idea What ALS stood for so here is a partial definition. If a fire fighter from our local station reads this perhaps he/she will provide the life saving efforts under ALS they are authorized to perform since there is a broad range.
I tried watching the video but there is no way to adjust the volume and the sound is way to loud.
ALS Terminology
In the United States, Intermediate and Paramedic level services are referred to as Advanced Life Support. Services staffed by basic EMTs are referred to as Basic Life Support. This terminology extends beyond emergency cardiac care to describe all capabilities of the providers.
ALS is a treatment consensus for cardiopulmonary resuscitation in cardiac arrest and related medical problems, as agreed in Europe by the European Resuscitation Council, most recently in 2005. It is practiced by in-hospital cardiac arrest teams, which generally consist of junior doctors from various specialties (anesthetics, general or internal medicine). Emergency medical technicians (EMTs) are often skilled in ALS, although they may employ slightly modified version of the algorithm
I want to thank Michael Walsh for his comments on my statements and his corrections and explanations of the situation with the CCHD.
The important point here is that the actions of the CCHD have reduced the chances of the average citizen receiving the quality of emergency care they had. The CCHD has reduced this service without any acceptable explanation to the public. This is their normal method of operation. They do not respond to any comments and will try to “just make it go away”.
I want to thank AboutCambria.com for picking up the story as it appears other media is going to let it pass. The only way this issue is going to be resolved is by the public demanding the CCHD reinstate the service or publicly explain the reason for their refusal to cooperate with Cambria Fire.
What I want the public to know is the CCHD’s possible reasons for terminating the service are bogus. The service costs $50.00 per pay period for three paramedics, less than $500.00 per month. CCHD provided the service for a period of approximately two years and there was no “liability insurance” problem during that time, Why now? The equipment is portable and during the time the service was active the equipment could be transferred to any ambulance at any time if needed. It never was transferred, and this was before CCHD bought two new ambulances to increase the number of ambulances to four.
So my challenge still stands. When will the CCHD come out of the dark and explain to the citizens why they have reduced their services and are risking Cambrian’s lives?
Where are the Citizens for Fiscal Responsibility? Why are they not following up on this issue. the CCHD gets property taxs, they charge over $1000.00 per ride to the hospital, they collect a benifit assessment on all improved and unimproved property, and they just passed the new tax. Thats 4 revenue sources. 1.4 million budget with a 1.2 million payroll? Could’nt we use some of that $ to put paramedic firefighters on the firetruck so they could be duel function and get more bang for our bucks?
A friend of mine sent me this information. I was a fireman for 31 years in Bakersfield. In the mid 70s our FD medic program was stopped by the local ambulance company. They wanted to provide ALS. During my last years one of my duties became EMS. After 25 years we finally provided limited ALS, but, our medics were still controlled by the ambulance co. We could only work in areas too dangerous for the ambulance crews; rescues, shootings & accidents. The Cambria FD should provide / manage ALS.
Why are the CCHD Board meetings not being broadcast on the local gov. channel? It’s not that they can not afford it. The tax payers deserve to have this option available to them. This public agency has been flying under the radar for far to long. How about it CCHD Board, if everything is tranparent, lets get your meetings on tv. I agree with Mr. Clift that we need to not make this about the employees but about the policy decisions that have been made, and will be made in the future by the Administrator (who retired at 90% of his salary, but is now back making a large hourly rate on top of his retirement ) and the majority of the Board members.