Changes Afoot for Texas EMS Response Protocol

University Medical Center EMS and Lubbock Fire Rescue are rolling out a change in the way they respond to emergency calls.

Starting July 18, dispatchers will conduct a more in-depth screening when a person calls 911 for a medical issue to determine what type of response is necessary.

Currently, emergency calls include response by an EMS truck and an LFR fire truck with lights and sirens, said Jeff Hill, vice president of support services at UMC.

After July 17, fire engines will no longer respond to every call and it could take longer than the current average of under five minutes for the ambulance to reach the call location for non-critical events. It takes LFR between four and five minutes.

“There will be situations where we’re going to send an ambulance and a fire engine with a lights response,” Hill said. “There will be other instances where we’ll only send an ambulance and there will be no lights. They’ll obey all the traffic signals and will move with the flow of traffic. Those would be the two types of responses.”

People exhibiting chest pain, difficulty breathing or serious hemorrhaging will be given priority response treatment, Hill said. The patient’s level of consciousness will also play a factor.

“There is a body of scientific evidence that has proven, except for cardiac arrest, response times don’t matter,” Hill said.

The screening questions are provided through The EMD Protocol: Medical Priority Dispatch System, which is a set of published standards by numerous emergency organizations, like the National Association of EMS Physicians, for medical dispatchers.

Dr. Gerad Troutman, EMS director, said the dispatch program is used by many EMS organizations throughout the country.

“It’s constantly verified and updated,” he said. “Although it looks like very simple questions, these questions are very good at ascertaining if this is a true medical emergency where we need to send everyone — lights and sirens. It does a very good job of finding those patients.”

The system should be able to help dispatchers discern life-threatening injuries from those that are non-life-threatening to determine whether LFR needs to accompany UMC EMS to the call, Troutman said.

Lance Phelps, chief of Lubbock Fire Rescue, said the change will help LFR save money.

“There will be some decrease in costs,” he said, particularly for fuel.

Phelps said LFR and UMC EMS have always worked closely in response to medical calls. LFR will still respond as necessary, he said, but an engine won’t be present at every call.

Fire engines typically serve as a shield at the scene for personnel and patients, Hill said, but they also carry a bigger advantage –extra sets of hands. When doing something as strenuous as CPR, the more people there are to trade off, the better.

“Every fire engine has a paramedic,” Hill said. “Having an extra set of hands to be able to help care for those patients is really important.”

It might take longer to get to the scene, but response time won’t affect the outcome of the patient, he said. And the changes do not mean first responders will neglect calls, he said.

“In no situation will we not send an ambulance,” Hill said. “We will always send help for every call. The difference is how we have that ambulance respond.”

EMS calls that do not include cardiac arrest symptoms will now only receive an EMS truck.

Having multiple emergency vehicles respond with lights and sirens is often unnecessary, though that’s how UMC EMS has traditionally responded.

“So, if you think about what we’re doing, we’re sending lights and sirens from two different agencies to 100 percent of calls,” he said.

National statistics show only 40 percent of ambulance calls are emergent and only 5 percent are life-threatening, according to a report called “What a Waste When the System Fails” at www.emergencydispatch.org/articles/Whatawaste.html.

Hill said UMC EMS falls in line with those statistics.

The priority response program will help more than just patients, Hill said. It will save resources and help keep emergency personnel safe, he said, citing vehicle accidents involving EMS vehicles.

There were two last spring, he said.

In both situations, the ambulance cleared the intersection and was hit by another vehicle turning in the opposite direction, Hill said.

“(Personnel) had to miss some time because of those injuries,” he said.

Phelps said LFR has had a few accidents, too, though none severe enough to force a firefighter to take time off.

Troutman said Lubbock citizens will be the greater beneficiaries of the change.

“So, ultimately, everything we do is about the patient,” Troutman said.

Hill said the program has been in the works since February 2015, adding that the rollout was in progress before the recent discussion among Lubbock City Council and hospital leaders about the future of EMS service in the city.

ellysa.gonzalez@lubbockonline.com

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