News

VIFR looks to bolster its medical response

By NATALIE MARTIN
For The Beachcomber

Vashon’s fire district is considering merging its paramedic services with south King County’s, a move some say could provide the island with better emergency response capabilities.

While there has not yet been an official proposal, officials with Vashon Island Fire & Rescue (VIFR) and King County Medic One are performing what VIFR Chief Hank Lipe calls a comprehensive overview of Vashon’s paramedic program. They believe absorbing Vashon’s eight paramedics into south King County’s rotation of 80 could provide the responders more experience, allow VIFR to focus more on its EMT and firefighter programs and perhaps even bring expanded paramedic coverage to the island.

Lipe briefed VIFR’s board on the idea at last week’s meeting and expects to have an official proposal for them to consider in a couple of weeks.

“The rest of the county is getting better service right now,” Lipe said. “We want to be a part of it. … We want to bring that level of service to Vashon.”

For years, Medic One — King County’s paramedic program — has contracted with VIFR to provide paramedic services on the island. Vashon’s eight paramedics, highly trained responders who handle the most serious medical emergencies, have the same training and follow the same protocols as those in the rest of the county, but work under VIFR leadership and out of the Vashon station, which receives more than $2 million in county levy funds per year to provide the service. VIFR also uses local levy funds to employ firefighters and emergency medical technicians (EMTs), who are trained to respond to less serious emergencies.

In recent years, however, calls for medical emergencies on Vashon have slowly risen, perhaps because of the island’s aging population. What’s more, medical transports have more than doubled in nearly a decade, rising from 271 ferry transports in 2005 to 714 last year.

ring merging its paramedic services with south King County’s, a move some say could provide the island with better emergency response capabilities.

While there has not yet been an official proposal, officials with Vashon Island Fire & Rescue (VIFR) and King County Medic One are performing what VIFR Chief Hank Lipe calls a comprehensive overview of Vashon’s paramedic program. They believe absorbing Vashon’s eight paramedics into south King County’s rotation of 80 could provide the responders more experience, allow VIFR to focus more on its EMT and firefighter programs and perhaps even bring expanded paramedic coverage to the island.

Lipe briefed VIFR’s board on the idea at last week’s meeting and expects to have an official proposal for them to consider in a couple of weeks.

“The rest of the county is getting better service right now,” Lipe said. “We want to be a part of it. … We want to bring that level of service to Vashon.”

For years, Medic One — King County’s paramedic program — has contracted with VIFR to provide paramedic services on the island. Vashon’s eight paramedics, highly trained responders who handle the most serious medical emergencies, have the same training and follow the same protocols as those in the rest of the county, but work under VIFR leadership and out of the Vashon station, which receives more than $2 million in county levy funds per year to provide the service. VIFR also uses local levy funds to employ firefighters and emergency medical technicians (EMTs), who are trained to respond to less serious emergencies.

In recent years, however, calls for medical emergencies on Vashon have slowly risen, perhaps because of the island’s aging population. What’s more, medical transports have more than doubled in nearly a decade, rising from 271 ferry transports in 2005 to 714 last year.

During a normal transport, one paramedic and one EMT take a patient on the ferry, leaving the island down a paramedic for three hours on average. A second emergency call receives one paramedic and at least one EMT. Officials say the situation isn’t ideal and isn’t how Medic One operates in the rest of King County, where paramedic teams never split up.

“Outcomes of patient care are better when you have two paramedics together the entire time during a call,” said Mark Brownell, a paramedic and the battalion chief for emergency medical services (EMS) at VIFR.

Also considered a weakness in the program, Brownell said, is that Vashon’s paramedics respond to far fewer calls than those on the mainland and therefore have fewer opportunities to practice their skills. While Brownell has high praise for VIFR’s paramedics, some of whom have decades of experience, he noted that the staffing on Vashon will eventually turn over, and everyone benefits from more on-the-job experience.

“When we sit down and analyze the sustainability of the program, there are some holes in the system that we currently employ,” he said.

Earlier this year, Brownell and Dr. Sam Warren, VIFR’s medical program director, outlined those holes in a formal letter to King County Medic One, spurring an attempt by both VIFR and Medic One to reexamine the program.

“I think it’s time to take a hard look at our paramedic system,” Lipe said. “We need to get ahead of the curve instead of waiting and going into crisis mode.”

John Herbert, Chief of King County Medic One, said the county is open to incorporating Vashon into south King County. For years, Herbert said, Medic One officials have been concerned that Vashon splits up its paramedic teams. He also agreed that paramedics benefit greatly from responding to a higher number of calls. He noted that he doesn’t let paramedics work in Enumclaw, the slowest part of south King County, for more than three months a year because of the low call volume there.

“Like anything, if you don’t do it very often, you can’t maintain those skills,” he said.

Absorbing Vashon’s paramedics would be fairly simple, Herbert said. After a transition period, the paramedics would likely go into rotation with the rest of south King County’s staff, sometimes working on Vashon and sometimes working in places such as Burien, Kent and Renton. In return, the island would see a rotating crew of paramedics who have been working in south King County.

Brownell noted that switching to such a program could mean less personal service, as many of the paramedics assigned to Vashon wouldn’t be as familiar with the island and its residents as the current ones.

“I’ve spend the night with people in the process of dying who haven’t signed up for hospice,” he said. “I’ve made meals for people. I’ve done all kinds of things.”

In addition, Vashon’s current paramedics are trained to fight fires as well, while those in south King County are not.

However, Brownell said fires account for just 10 to 20 percent of VIFR’s calls, and he believes less personal service is a small price to pay for having paramedics with more experience. In addition, all but two of Vashon’s paramedics already live off-island.

The big question now, according to Herbert, is what would happen when a patient is transported via ferry to the hospital. Medic One would not split the Vashon paramedics, he said, but they also don’t want to leave the island without paramedic service.

Lipe said ideally Vashon would get two more paramedics out of the deal. If there were four on duty at all times, rather than two, he said, transports would be much easier to handle and islanders with serious medical emergencies would more often see two paramedics respond.

Herbert said the county will consider adding one additional paramedic on Vashon, but even that is unlikely, as adding one paramedic position means hiring at least four people to fill shifts and could cost more than half a million dollars.

The county is exploring other options, Herbert said, including bringing on a paramedic who would serve as back-up but could also fill other roles at the station. They are also looking at the feasibility of sending an off-island paramedic to the island anytime Vashon’s team leaves on a transport. They’ve even considered sending extra medics quickly by helicopter or boat, though such a plan would be weather dependent.

“We’re looking for a 24-7 way to provide that service, regardless of weather or time of day. That’s our challenge,” he said.

Lipe said he and Herbert hope to have a plan to present to VIFR commissioners this month. The station will also seek feedback from staff and the public, likely holding a public hearing on the topic. Any plan, Lipe said, would not involve seeking more tax funding from islanders, but ideally would allow the station to focus more of its existing funding on training and supporting EMTs and firefighters.

Before any changes are made, any plan must be approved by VIFR’s board and the general Medic One board, called the EMS Advisory Committee, as well as the King County Council and Executive Dow Constantine.

Two VIFR board members, Camille Staczek and Candy McCullough, said they’ve been happy with Vashon’s paramedic service, but they’re willing to consider another direction.

McCullough agreed it would be ideal to bring more paramedics to the island, but said she realized that may not be possible given Medic One’s budget constraints.

“There’s going to have to be some compromise between having it all and having what we have,” she said. “Everybody is working toward it.”

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