EMS Study Tour Completes Circuit of Southwest U.S.

The "EMS Diversity in America" Study Tour traveled the Southwest U.S. Oct. 7-14 visiting private and public EMS services from Los Angeles, CA to Las Vegas, Nevada where participants spoke at EMS EXPO on Oct. 16, 2008.

Final entries coming soon!

Day 5: Dispatches from Tucson, Arizona

Southwest Ambulance, a unit of Rural Metro Corporation, operates both ambulances and fire trucks in Pima County and other contracted areas in southern Arizona. Arizona has interesting laws governing EMS. Service areas, rates and some performance standards are regulated by the state of Arizona through its state lead EMS office. As such, ground ambulance services can only operate in a specific area by a process called certificate of necessity (CON). BLS and ALS services can have separate CONs in the same geographic service area.

Marco Rivera oversees both fire and EMS operations in the Tuscon/Southern Arizona area. With 567 employees, most of whom are with the EMS Operation, Southwest provides ALS services to several areas outside the city of Tucson and it handles all BLS transports within the city of Tucson. Tucson Fire Department transports all ALS patients within the city.

With all operations combined, Southwest does upward of 100,000 calls per year, a very busy operation. They also provide secondary PSAP services for their own fire and EMS operations as well as provide contract dispatching for several area jurisdictions. As with other Rural Metro PSAPs, they utilize National EMS Academy EMD and medic priority dispatch system (MPDS). They also operate their own fire training academy in Tucson.

Todd Pearson is the Deputy Chief for EMS operations with Tucson Fire Department (TFD). Tucson Fire runs about 76,000 calls per year including both fire and EMS responses. As with most other fire-based EMS operations in the US, 80% of those calls are EMS. They operate 17 paramedic-staffed trucks for transport of ALS patients only. Rural Metro transports all BLS patients under contract with TFD.

The Tour Group was both surprised and honored when Chief Pearson read a proclamation from the honorable Robert E. Walkup, Mayor of Tucson, proclaiming the date of our visit, October 11, 2008 "Emergency Medical Services Day in this community," and encouraged "all of our citizens to support the many public safety activities and efforts of Tucson's emergency services professionals." Tour group members acknowledged the honor and thanked Chief Pearson for his extraordinary efforts on behalf of the City of Tucson.

Tucson Fire is implementing a high tech program that places remotely operated video cameras both in the ambulance patient compartment and on the rear of the vehicle. These cameras transmit both patient management and scene information to the base hospital -- University Medical Center in Tucson. The base station docs can remotely operate the cameras and even zoom in on a shot or patient to see what is happening at the scene and in the ambulance. The doc can also appear on a screen in the patient compartment and provide advice to the paramedic treating the patient. This all operates on a city wide M.E.S.H. network.

Related Video: Tucson Telemedicine

Tucson Fire has a human services referral program by which paramedics can access a local web site at any of their fire stations and make an on line referral for social services needs for patients they see in the field, whether or not the patient is transported.

A truly landmark innovation involves putting "Alpha" trucks in all TFD fire stations. The PSAP uses the MPDS to dispatch them to low acuity 911 calls. Alpha trucks are pickups that can respond code 1 or 2 to a scene, assess a patient and then take the time at the scene to help that patient get help through a long laundry list of social service programs available in the city of Tucson.