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Emergency Response: Missouri & Kansas Hospitals Reach a New Agreement

ST. JOSEPH, Mo. -- Lesley Watson has turned her husband's death into a crusade for change in emergency medical response.

Already, Mrs. Watson's efforts have produced one result: Heartland Regional Medical Center and Atchison (Kan.) Hospital have agreed to alter an agreement to allow ambulances to respond from Kansas into southern Buchanan County to answer medical emergencies, vehicle accidents and the like.

Lorne Archer, chief financial officer for Atchison Hospital, said he expects the revised agreement will take effect this week. Atchison emergency medical services will be able to respond within the part of Buchanan County south of Rushville to the Platte County line and west to the Missouri River, Mr. Archer said.

The change comes too late for the family of Rick Watson and their attempts to secure assistance for the 42-year-old St. Joseph man who suffered a heart attack in late August at Lewis and Clark State Park in southern Buchanan County. But the restructured pact may help others who need a quick medical response for a family member, Mrs. Watson asserted.

"People don't realize it can affect everyone," she said. "I don't want any other family to lose a child or loved one."

Mr. Watson was spending time with his family at the park when he suffered a heart attack on Aug. 20.

"We immediately knew we had to do CPR (cardiopulmonary resuscitation)," Mrs. Watson said.

An ambulance failed to arrive after 911 was dialed. The family discovered that the Atchison 911 computer system was undergoing renovations and didn't have a means to relay the calls to other agencies, Mrs. Watson said. An Atchison dispatcher told the family the agreement prevented its ambulances from responding across the Missouri River -- even though its hospital is closer to the park than the nearest hospital in St. Joseph -- unless requested by Heartland or other licensed Missouri providers. The dispatcher gave Heartland's 10-digit phone number to the caller.

First responders from the Southwest Buchanan County Fire Protection District arrived, followed by ambulances from both hospitals. Atchison paramedics used a defibrillator on Mr. Watson and took him to Atchison Hospital, where he was pronounced dead. From 55 to 60 minutes had elapsed from the first phone call to Mr. Watson's arrival at Atchison Hospital, Mrs. Watson estimated.

The situation spotlighted confusion in a two-year-old agreement between the hospitals on mutual aid response. The circumstances also involved the lack of an enhanced 911 system in Buchanan County, which Mrs. Watson said would have assured proper cell phone contact with the responsible agency, and allegations over first responder training.

Meetings with Charlie Shields, Heartland's marketing director, led to the call for changes to the mutual aid policy.

"The closest ambulance needs to go," Mrs. Watson said.

Mr. Shields agrees with her goal.

"If somebody can get to that patient faster than we can, that would be fine with us and that would be our preference," Mr. Shields said. "I think we're all very confident that's where we're headed. Both sides are treating it with a lot of urgency."

Heartland Paramedics Director Tom Little said the hospital doesn't stage an ambulance in the southwest corner of Buchanan County. There were 17 ambulance calls in that portion of the county for all of 2006, he added.

Heartland will donate an automatic external defibrillator to the park staff, Mr. Shields said. Atchison Hospital has agreed to pay for half of the unit's cost, he added.

Mr. Archer said the details of the reworked agreement -- such as what must happen if both Atchison ambulances are detained -- must still be written.

"Procedures and process in health care are always being evaluated," he said.

The concerns with cell phones reaching 911 would be addressed by voter approval of the capital improvement sales tax issue on Nov. 6, Mr. Shields said. The added technology would provide pinpoint location of cell phone callers. Mrs. Watson said she'll lobby for any innovation that adds GPS to cell phones.

The efforts and skill of Southwest Buchanan's first responders remain in dispute, however. Mrs. Watson criticizes a lack of training in areas such as intubation and familiarity with gear such as defibrillators.

"All I asked for was people to stand up" and undergo first responder training, Mrs. Watson said.

Southwest fire Chief Andrew Johnson defended his department. He said he investigated the call, although he didn't accompany the first responders.

"My first responders acted as they were trained," he said. "They acted according to the book."

It's the mission of first responders to sustain life with basic techniques until an ambulance arrives, Mr. Johnson said.

"They can't be asked to do any more than what they were asked to do," he said.

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