Maryland Program Helps Reduce Paramedic Response Times

When a heart stops beating, the time starts ticking for county paramedics to get to the patient's side.

But often, the paramedic team stationed nearest to an emergency is tending to another person in distress - forcing dispatchers to call on the next closest firehouse to send an ambulance to the scene.

That scenario has caused some county paramedics to fall short of the national standard on their times to respond to medical emergencies in recent years, with some going as much as 5 minutes over the limit, said Battalion Chief Matthew Tobia, a county Fire Department spokesman.

But fire officials are crediting a pilot program to strategically use their paramedics with turning the problem around.

Faced with a shortage of funding and staff, the department's options are limited. But by shuffling employees, further educating firefighters and equipping fire engines with paramedic equipment, the new program is proving to be a good option in a pinch.

Basically, department officials are spreading out their paramedics to be able to respond to more calls.

In 2006, paramedics in 10 areas around the county's 30 fire stations were taking longer than the 6- to 8-minute standard set nationwide by the American Heart Association, Chief Tobia said. The trouble spots are spread throughout the county, from Lake Shore to Harwood and Deale.

Since the implementation of the pilot program in mid-2006, all but two of the 10 fire stations over the limit met the national standard last year, Chief Tobia said. Herald Harbor is still over the mark by 26 seconds, and the Annapolis Neck area is 36 seconds over the 8-minute standard.

That's because the Annapolis Neck relies on the city's Eastport Fire Department to handle medical emergencies, Chief Tobia said, adding precious seconds to their responses with the additional level of communication. County fire officials said they expect the response time to decrease "considerably" in that area with the introduction of the new Annapolis Neck Fire Station, slated to open off of Bay Ridge Avenue in April 2009.

A domino effect

Department officials said the problem was a "domino effect." For example, if the paramedic unit in Avalon Shores in south county is at a medical call, a second emergency that requires paramedics must rely on a unit from Harwood to respond.

In the meantime, if a critical medical emergency happens in Harwood, an paramedic ambulance from Deale is called in to help.

"When something happens in Brooklyn, it can be felt in Harwood-Lothian," Chief Tobia said.

Often, the two paramedics assigned to each ambulance aren't both needed at the emergency. This commonly leaves the skills of one paramedic at each scene not being used to their fullest capacity, Chief Tobia said.

While ambulances are running from call to call, several of the county's 30 fire engines are parked in the bay, waiting for a blaze or less-traumatic medical emergency to respond to.

That's why when a frantic caller dials 911, a fire truck is often first to arrive at the scene. Plus, there are 10 more engines than ambulances in Anne Arundel.

"One of the most common questions we get is, 'Why is a fire truck showing up to my house when I called for an ambulance?' " Chief Tobia said. "It's because often, because of call volume, it's likely an ambulance is already out on a call. We send as much help as quickly as we possibly can. A fire truck is usually what is closest and available."

Generally, fire engines are only staffed with firefighters. All county firefighters have the 120 hours of training required to be certified emergency management technicians, or EMTs, meaning they have basic techniques, like cardiopulmonary resuscitation and using an automated external defibrillator.

But only a paramedic, who has 2,000 hours of advanced training, can provide care in certain life-threatening emergencies, such as giving a patient intravenous medications and applying a pacemaker, Chief Tobia said. And the paramedic response-time clock doesn't stop ticking until they've arrived on the scene.