Houston Fire Chief Revises Dispatch Policy

Responding crew has the authority to upgrade the call while en route, based on additional information.


 
 

JAMES PINKERTON, Houston Chronicle | | Friday, November 11, 2011


Houston Fire Department officials estimate that vehicles sent by dispatchers in nearly 2,000 emergency medical calls since August didn't have sufficient equipment or personnel, requiring them to upgrade the call by sending an ambulance equipped for advanced life support treatment.

The disclosure about the calls comes on the heels of Fire Chief Terry Garrison recently revising his controversial dispatch policy - with little fanfare - by allowing firefighters on an emergency run to request an advanced ambulance before reaching the scene.

Garrison changed Houston's long-standing dispatch policy Aug. 1, requiring fire engines, ladder trucks and basic ambulance crews sent on low-priority emergency calls to reach the scene to assess a patient before calling for an ambulance with advanced life support.

The new policy came under criticism after the Oct. 21 death of 4-year-old Rebecca Woodruff, who was accidentally run over in the driveway of her Kingwood home by her mother who called 911 and pleaded for an ambulance. A fire truck arrived first and an ambulance arrived soon after, prompting criticism by the family and a City Council member.

Garrison has declined to give specifics about the Kingwood call, explaining the department is investigating to determine if the emergency call was handled properly.

Garrison has said the fire engine was the nearest available vehicle to the Kingwood accident, and the fire truck crew included firefighters trained to provide emergency medical treatment.

Upgraded calls

Assistant HFD Chief David Almaguer, who is in charge of emergency medical services, said the department is finalizing a report on all EMS calls from Aug. 1 to Oct. 31, the first three months of the new dispatch policy. He did not know the exact number of calls dispatched as low priority but later had to be upgraded with an advanced ambulance.

However, Almaguer estimated that nearly 7 percent of the low-priority EMS calls, or about 2,000, have turned out to be patients who needed to be transported to the hospital and received some advanced life support treatment on the way.

He said that in the dispatching world of determining what level of care is needed by a patient - by questioning a person during a 911 call - the 7 percent figure is "very good."

According to an HFD memo, Garrison made the "major revision" to the new policy Nov. 1, giving the HFD responding crew the authority to upgrade the call while en route, based on additional information forwarded by radio or computer about critical or life-threatening injuries. The chief said the revision was not related to the Kingwood accident.

'An Improvement'

The chief said the policy enacted in August, called "All Hazards Response Program," is used in other large cities. He said it's intended to prioritize ambulance runs by dispatching the closest HFD vehicle, including fire engines and ladder trucks, to handle low-level emergency calls.

He stressed the policy does not change the way ambulances are dispatched in critical situations.

"We have 50 ambulances in the city of Houston," Garrison said. "If we send an ambulance on every call, the ambulances would have to run an average of 800 calls on a 24-hour shift over 600 square miles. Obviously, they can't do that."

City Council member Mike Sullivan, who has been sharply critical of the new HFD dispatch policy, said the revision was a positive step.

"That's an improvement because prior to Oct. 31, the firefighter could not do that," Sullivan said. "He had to literally arrive on the scene, make an assessment, and then call for an ambulance."

Garrison said the new policy has already improved response time.

"We're getting on the scene about 34 seconds faster, and half a minute is pretty important," Garrison said.

Jeff Caynon, president of the Houston Professional Firefighters Association, said changes to HFD's dispatch policy have ignited a deep controversy among Houston firefighters. But he said few in the department would disagree that the previous dispatch policy didn't need changes.

"Too much of the time we were sending too much, and we knew that," Caynon said. "We were sending ambulances, and paramedics and supervisors and heavy apparatus on calls that didn't need that level of response."



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