Lack of EMS in Rural Texas Puts Residents, Visitors at Risk


| Wednesday, February 6, 2008

CORPUS CHRISTI, Texas -- The wide-open spaces of rural Texas are attracting more residents. They escape urban congestion and higher city taxes. But the lure of the rural life has its down sides, one of them being the very services that a city can provide, such as emergency ambulance service.

Residents of southwest Nueces County are struggling with the problem of emergency ambulance service. The city of Bishop until two years ago had ambulance service, which helped fill a gap in that area. But since the private service closed the problem of emergency ambulance service has worsened, residents told writer Dan Kelley.

This is an important issue because lives are at risk. This applies not only to rural residents, who live with the problem, but to nearby urban residents as well. Motorists driving the highways outside of metropolitan areas may need emergency ambulance service if they are involved in an accident, or if they find themselves in an emergency medical situation, such as a heart attack.

Some studies say that although rural areas have fewer accidents, perhaps because there are fewer residents, those emergencies that are produced tend to be more severe and more traumatic. That's because they often involve high-speed road accidents, some with multiple victims, or accidents involving heavy machinery. The gap in emergency ambulance service could be crucial in reaching trauma victims in what experts call the "golden hour," that window of time when emergency aid and transport is critical.

The county has five rural emergency districts that levy property taxes that sustain volunteer fire departments in the outlying rural areas. But the low tax base in those districts, those who have studied the issue maintain, can't sustain an emergency ambulance service in such a large area. Corpus Christi's metropolitan ambulance service, its officials say, has responded to rural calls, but is discriminating in what kind of calls it answers and tries to find alternative ambulance service, if possible.

The county leadership is aware of the problem. Mayors and fire chiefs have met to assess the situation in recent months and the Nueces County Commissioners Court has been briefed on the issue. Some believe an interim solution is to train and possibly equip the present first responders in rural areas on how to stabilize patients until an available ambulance responds. That may be fine as a temporary bandage for the lack of any ambulance service, but lack of emergency ambulance service is a problem across Texas, especially as the state heavily urbanizes and what were formally strictly rural areas become more populated.

The state is lacking in models for funding and equipping rural emergency services, Recent major evacuations, such as the 2005 evacuation from the Houston-Galveston metropolitan area in advance of Hurricane Rita, would seem to call for a framework for rural emergency services in the context of state emergency preparedness.

As the interim committees for Texas House and Senate take up their charges between sessions, they ought to tackle the issue of providing emergency rural services that every Texan may need whether he or she lives in a rural area or not.

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