Lawmaker Says Nebraska is Stalling Rural Rescue Efforts

BATTLE CREEK, Neb. -- Rural residents depend on volunteers for timely and professional emergency medical care every day.

Now, some of those volunteers say, Nebraska law is standing in the way of them doing their jobs.

A state lawmaker proposes to fix that by expanding the authority of volunteer first responders during emergency medical calls.

The measure would give first responders the authority to transport patients without other medical workers present.

The state Emergency Medical Services Board opposes the measure, which State Sen. Mike Flood of Norfolk says he will introduce in next year's legislative session.

Currently, first responders in Iowa and Nebraska can participate in the transporting of a patient only if an emergency medical technician, physician or nurse is with them.

First responders are trained to stabilize patients while other help is on the way. They can open airways, perform CPR, control bleeding and bandage wounds, among other things.

In recent years, the rosters of rural rescue squads have dwindled, due in part to declining populations as well as stringent testing requirements.

Battle Creek, population 1,158, has 32 volunteers on its fire and rescue squad. Seven are certified emergency medical technicians, and two of them are certified first responders.

On a recent afternoon, the area nursing home requested that an elderly man complaining of chest pain be taken to the hospital in Norfolk. Two first responders, including Fire Chief Scott Lyon, showed up at the scene, as well as several other firefighters.

No emergency medical technicians were in town to answer the call, so Lyon put out a second call. Nobody responded.

More than six minutes after the original request from the nursing home, a third call for help went out. This time, an EMT in neighboring Meadow Grove responded. By the time he arrived, Lyon estimated, nearly 30 minutes had elapsed.

Flood said that over the past few months he has heard from most of the volunteer rescue squads in Madison County describing similar situations.

"Our rural towns just don't have enough people in town during the day to be able to handle the call,'' he said. "My biggest fear is somebody in the community will need the ambulance, and there will be a considerable delay as we wait for another agency and another rescue squad to assist the person needing help."

Lyon said that allowing first responders to transport patients, even when EMTs are not present, would make better use of their volunteer roster and serve patients more quickly.

He said he is certain that first responders can safely assess whether they can handle a patient's condition. If they can't, he said, they would put out a call for an EMT.

Said Flood: "I have no interest in watering down (state) regulations to compromise patient safety."

But some experts say that is exactly what Flood's proposal would do.

Dr. Gregg Margolis, associate director of the National Registry of Emergency Medical Technicians, said that allowing first responders to transport patients poses serious risks.

The first responders' role, he said, is "to provide immediate interventions for life threatening emergencies while awaiting additional resources. Once you step outside of that role, you are stepping outside the scope of their training.

"The decision as to whether you need more help is one of the most complicated decisions in medicine. It requires a considerable amount of experience, education and training," he said.

Dean Cole, who runs the state Emergency Medical Services program, said there may be other ways to improve the response times of rescue volunteers in rural areas.

Cole said consolidating services among neighboring communities can help maximize the manpower available for rescue calls.