ALS transfers are EMS extra
When a cardiac patient at St. Luke Hospital or Hillsboro Community Hospital needs to go to a larger medical center, doctors call for a Marion County ambulance with advanced-life-support (ALS) capabilities.
Whether they get one depends on how a dozen qualified volunteers are scheduled, and how their skills match up with what a patient needs, county Emergency Medical Services Director Brandy McCarty said.
Marion County ambulances have basic-life-support licensure, and the majority of volunteers are basic EMTs. Ambulances may be used for ALS if a qualified individual is available.
“We’re not required to always have ALS staff available,” McCarty said. “We’re just the lucky ones that we have ALS people.”
Nine volunteers are certified as advanced EMTs (AEMTs). Three more are paramedics, the highest level of emergency medical responders. They differ in the medications they can administer, the conditions they can monitor, and the procedures they can do.
These dozen volunteers aren’t distributed equally across the county. Marion has one AEMT, while Tampa has five. Peabody and Hillsboro have paramedics in addition to AEMTs.
Scheduling isn’t centralized. Crew captains in each town draw up schedules of two-person teams. When an AEMT or paramedic is on the schedule, that pairing is an ALS-capable team, McCarty said.
When all the variables are considered, it’s common, for example, to find a Peabody crew doing an ALS run from Hillsboro, or a Hillsboro crew being dispatched to Marion.
Less common is a situation where no ALS crew is available, or a crew has an AEMT when a condition demands the skills of a paramedic. When EMS doesn’t have a crew for advanced life support, what happens?
That’s when the hospitals step in with a nurse, and on rare occasions a doctor, to provide the medical support to transport the patient with ALS needs.
“That’s a community service St. Luke provides,” Chief Nursing Officer Gail Boaldin said. “Our nurses are advanced cardiac life support certified, and that’s what makes us capable to go.”
When a nurse on duty couldn’t ride along in an ambulance because the hospital had to have them for other patients, Boaldin said she’s called off-duty nurses to come in for a call.
“Since I am ACLS certified as well, I’ve gone,” she said. “We’ve even had physicians in town who have said, ‘If you need somebody to go, I’ll go.’”
If it all seems a bit complex, it is, McCarty said. What she wants county residents to know is that between EMS volunteers and hospital staff, patients will get where they need to go.
“With us being rural and a volunteer service, we are doing a wonderful job for what we have,” McCarty said.