Wednesday, February 25, 2004

An ambulance in your neighborhood?

By SALLIE SATTERTHWAITE
sallies@juno.com

It was one of those “worst case scenarios” public servants talk about while they are drawing up budgets and allocating manpower and equipment.

But this was real.

A pre-dawn blaze was ripping through a Peachtree City condominium. The first-arriving units reported flames visible. Firefighters would soon discover that a woman was already dead, only the second fire death in the city’s 40-year history.

Nationally accepted fire standards state that the first apparatus should get to an apartment fire within four minutes. A full complement of 22 or more firefighters and apparatus should arrive within eight.

Peachtree City’s fire department mustered only 15 that night. Of that number, two volunteers left early to go to work, and two FireMedics took a resident of the building to the hospital.

That left 11 firefighters to battle the fire. In theory, two of them should have stayed clear of the blaze to provide first aid or rehabilitation as needed (now required by Occupational Safety and Health Administration).

And, while this was going on, two medical calls in the city had to be handled by Fayette County EMS.

Although a report by Fire Chief Stony Lohr says, “The fire victim was most certainly dead before we arrived,” citizens wonder if better staffing could have saved the homes and belongings of five families who lost theirs.

When Dave and I joined the department about 1973, Peachtree City had one fire station and one ambulance (which covered all of western Fayette County). We ran 250 to 300 calls a year when the city’s population was under 3,000.

In 2002, PCFD ran 542 fire calls and 1,610 emergency medical calls. In 2003, nearly 1,700 calls were medical, 565 fire.

Last year ­ The Year of the Consultant, some called it ­ City Hall contracted for $17,000 to find out what the fire department would gladly have told them for free. They didn’t know that Chief Lohr is a walking, talking, calculating consultant who heads a department that knows exactly what it needs?

And if he should miss something, an alphabet soup of bureaucracy ­ NFPA (National Fire Protection Association), OSHA, and ISO (Insurance Service Organization) ­ is ready to help.

Actually, ranking officers in the department were unconcerned about consultants like Emergency Services Consulting, Inc. They figured that City Hall might, having paid for their recommendations, respond more favorably to requests for personnel. Predictably, members of the department loved the report when it backed up their opinions, scorned it when it did not.

Worse, however, were the errors in the ESCI report, contradictions and misrepresentations that cast doubt on its overall efficacy. Department review resulted in 18 single-spaced pages of comments, most of them asserting that a given recommendation was already in place, and had been for some time.

Where possible, the chief put a price tag on some suggestions, to explain why the department had not pursued them before. ESCI, for instance, suggests a “satisfaction” survey be provided to each user of the system, to monitor its effectiveness. Agreed, Lohr replies, but it will cost another $1,000 a year.

ESCI would like to see a regular newsletter go out to the public. Sure, says Lohr. Who’s going to fund the $4,000 per issue? But when ESCI suggests distribution of all staff meeting minutes, Lohr disagrees and lists 21 sources of information already in place, most of them regular meetings, e-mail, and Web sites.

Personnel, however, is a more serious matter. As far back as 2001, the ISO stated that Peachtree City needs three fire stations in addition to the four we have now, with personnel to staff them. The ESCI report also would add duties to officers such as the fire marshal and a public fire and life safety educator, without support staff.

The most appalling ESCI recommendation is to cut the number of ambulances in service from four to two, using fire engines to deliver advanced life support and personnel. We already respond an engine if it is closer than a medic unit. This comes as a shock to the patient’s family: “We called for an ambulance and got a fire truck!”

An ambulance must respond too. Citizens use terms like “general weakness,” which could mean anything from exactly that to cardiac arrest.

Lohr says, “We cannot provide reliable professional community service by sending one investigatory unit and waiting for them to call for what should have been there in the first place.”

But think about it for a moment. In 1990, when about 20,000 people lived in Peachtree City, we went from two to three ambulances. The population of Peachtree City is now 35,000 and ESCI wants to reduce to two an already strained fleet and staff?

With only two medic units available, the department will not be able to stand by for public events. With only two medic units, the admirable response time of four minutes, 10 seconds will be severely compromised.

Consider this, too: Between February 2002 and February 2003, there were two simultaneous calls 207 times. Three simultaneous calls went out 27 times, and so on; the record was six calls at once.

On Oct. 28, 2003, all our ambulances were in service and we had to call in Fayette County. There have been several times when there was not one single ambulance left in both Fayette and Coweta Counties.

Of course, this isn’t the Peachtree City of the 1970s. When we arrived, there were maybe a half-dozen manufacturing facilities on Dividend Drive, and one school, the elementary school on Wisdom Road, Flat Creek Golf Club, one church (only a story-and-a-half high), a one-level doctor’s office, a single-runway airport, and a “quickie”/gas station. The rest of the structures were one- or two-story residences, mostly single family, for a population under 1,000.

And today? The city has more than 11,000 residences, a nursing home and an assisted living facility (and soon a three-story senior facility). We have seven schools, 22 churches, 17 apartment and condo complexes. There are two lakes, two state highways, a railroad with about 30 trains daily, two large convention centers, Home Depot and Wal-Mart, the busiest FAA TRACON facility in the world, an airfield with a 5,200-foot runway, 300 aircraft, and an industrial park, in which the largest structure is about 700,000 square feet. Did I mention six shopping centers and how many sports venues?

We’re going to protect all that with two ambulances and no additional personnel?

The chief classifies most of the structures itemized here as high risk or maximum risk, for which NPFA standards require 22 to 31 firefighters for an effective initial response. The alternative is to defend adjacent properties and let buildings and their contents burn.

Now it’s up to City Hall.

If we can’t meet state and national standards, nor perform routine tasks without outside help, how can we expect to deal with a major emergency?

How long will it be before a firefighter dies because he had no backup, and why is the city willing to expose itself to this kind of liability?