Prehospital Profiles: Grand County EMS

Located in the rugged Rocky Mountains and featuring a specialized Mountain Medical Response Team, Grand County EMS in Granby, CO, is a small service with a big heart.

The 38 dedicated employees handle emergencies in local city centers as well as in the wilderness, often working hand in hand with the all-volunteer Grand County Search and Rescue Team to aid skiers, mountain bikers and others in the challenging mountainous terrain.

“These are the events that really tax us,” says Chief Ray K. Jennings Jr. “They can last up to 30 hours, and we work in very extreme conditions. This past week was 20 below zero with ice and wind.”

In addition, the three local medical facilities are two Level 4s and a Level  5, so it’s common for patients to require ambulance transport to Denver for higher level care.

On average, it takes a couple of hours for a transport to Denver, but in difficult winter conditions it can take 8-10. “By the end of the day we could have been on a snowmobile or even a horse,” Jennings says.

“We don’t look at the Golden Hour. We look at the Golden Day.”

Running Calls in Grand County

To get into the backcountry they have a 6-wheeler ambulance, two snowmobiles and two ATVs, and they have at times ridden horses or hiked up to 10 miles. “It’s a very rigorous environment,” Jennings says.

As a result, fitness is a key requirement for backcountry responders, as well as avalanche and high altitude training. Equipment carried on ambulances includes blanket warmers and backcountry backpacks with wilderness response gear.

All of the ambulances for 911 service are four-wheel drive, and the 2010 ambulances feature an extended cab for patient families, additional personnel and cold weather gear.

"The 2014 Dodge ambulances are where technology has met the ambulance," Jennings says. These ambulances feature a four-door, full-size cab for patient families, additional personnel and additional gear. They also feature the Liquid Spring kneeling system which utilizes silicone, not air; the Mermaid side by side warmer and cooler for medications, etc.; and the Espar auxiliary heater, utilizing the truck fuel system. "A very modern approach to responding to calls in the rural mountain area," Jennings says. In addition, all of the ambulances feature a back-saving device from Zico for lifting in and removing the house oxygen bottle.  

As for the calls they run the most—“We see lots of broken bones,” Jennings says.

Trauma related injuries are most common, usually due to falls off trails and accidents from skiing, ATVs, and snowmobiles, which often result in head injuries and fractures to femurs, backs and the pelvis.

The next most common calls are cardiac, and then respiratory, often because visitors have difficulty with the high altitude. The community also has some children with specialized medical needs.

Providing the Highest Level of Service

The service has eight critical care paramedics and a full-time training division.

“That’s not the norm for a system our size,” Jennings agrees. Grand County EMS is aggressive in their training and requires the high number of critical care paramedics because of the wide range of patients they face and because of their long inter-facility transports. They need to manage patients with issues including chest tubes, multiple drips and ventilators.

What is also unique about GCEMS is that they provide the Office of Emergency Management for Grand County. "This is an additional aspect which further provides a diverse and unique approach toward preparing, responding, and mitigating natural and man-made disasters," Jennings says.

Community Support and Funding

Grand County EMS has always had the community backing needed for them to grow into a strong service,  Jennings says.

The organization started in 1970 as a Basic level ambulance provider. “As the years moved forward, so did the ambulance service,” he says. They implemented EMT-Intermediates in the 1980s and then paramedics in the 1990s. 

As Grand County became a destination for tourists, bringing in 1-4 million visitors per year and substantially increasingly the call volume, they became a full-time paid EMS service in 2001. Then in 2003, county citizens stepped in to support EMS through a new property tax.

Their budget is now $3 million per year, with 1.4 million coming in through the tax subsidy and the remainder from fees and grants. Jennings says they charge for services, including training and education, and look to grant funding whenever possible for equipment.

What’s special about their model is that when the property tax was written, it stipulated that Grand County EMS was to operate within those budget parameters, and would not take from other departments.  As a result, “We treat it like it’s a business,” Jennings says, and look from year to year at factors including the economy and health care changes, and adjust accordingly. “We’ve adapted successfully so far,” he says.

The EMS department has also worked to build strong relationships with the area fire departments and medical facilities.

“It’s all become essentially one team… we’re a family and do very well together,” Jennings says.

The relationship building has been actively developed over the last 10 years, his tenure there, Jennings says. “Like a magnet, it draws people toward you.”

Giving Back

As another way to service the community, Grand County EMS runs a “Grown Your Own” program in which they provide the only high school-based EMT program in Colorado.  The students train to become EMTs, take the National Registry test and have the opportunity to apply for internships and even to work there. “We provide them with job-ready skills; it’s a wonderful thing to do for a community,” Jennings says.

GCEMS also has a very strong public/private AED program, with more than 60 AEDs placed throughout the community and training for an average of 500 people each year. They also provide car seat safety inspections and fight the battle for the "Stay Alive—Don't Text & Drive" campaign.

Jennings notes that GCEMS is an award-winning organization; in 2010 the staff received the Colorado Ambulance Service of the Year award, and in 2013 they were awarded the Colorado Children's Hospital Provider of the Year.

Facing Their Own Tragedy

Grand County EMS is mourning the loss of a member in the first line of duty death in the department’s 43 years. Former EMS Captain Brian Schimpf, 33, died Nov. 23, 2013 after experiencing complications in the surgery he underwent that week to address injuries sustained in a 2012 crash. Schimpf was returning from a structure fire at around 2 a.m. on Sept. 7, 2012 when the accident occurred.

A local memorial service was being held for Schimpf this week.

Still Fortunate

Despite the additional challenges of operating in a difficult environment and facing their first personal tragedy, the service always strives to maintain a positive atmosphere, and as their slogan says, provide "Professional care with a personal a touch."

“The people are amazing and very dedicated, to say the least,” Jennings says of his staff.

“We’re very fortunate for where we’re at… the uniqueness of what we do has made it very interesting for us.”

For more information see the GCEMS website at www.grandcountyems.com.