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Burke County Places Trial EMS Station in Rugged Area to Determine Needs, Response Effect

ICARD, N.C. - South of I-40 in Burke County, in the rugged territory dominated by the South Mountains, an ambulance may need 30 minutes or more to reach the site of an emergency. Burke County EMS hopes to reduce that response time by establishing a new base in the county's South Zone.

The Burke County Board of Commissioners on Monday appropriated $84,000 to set up a trial EMS base. The appropriation covers estimated costs for five months operation while Burke County EMS collects real-time data about calls, response times and costs. The initial site will be in the Ruritan Club's building near the George Hildebran Fire Rescue station about 6.5 miles south of I-40. That may not be the permanent station's location. EMS Director Randy Price said it's somewhat east of the ideal site, according to an analysis of calls between Oct. 1, 2008, and Oct. 1, 2009. However, Price said, the data clearly showed the "South Zone" is "in desperate need of EMS presence."

Establishing and operating the temporary base in the first half of 2010 will help Burke EMS produce a permanent solution to the problem. The department's analysis of 12 months' worth of emergency calls is that most come from three areas defined by their volunteer fire departments' coverage. The three are George Hildebran (558 calls during the year), Enola (98) and South Mountain (68). Average response times were close to 24 minutes, ranging from an average of 19 minutes in the area served by Enola Fire Department to an average of 32 minutes in the South Mountains Volunteer Fire Department's region. The statewide average response time is 13 minutes. In some situations, even that is too long. Price quoted a Johns Hopkins medical study that found the chances of survival after cardiac failure drop 7 to 10 percent in every minute without defibrillation -- and "after 10 minutes survival is unlikely, as approximately 95 percent ... die before reaching the hospital."

Based on what they learned about response times in Burke County's South Zone, according to a detailed report written by Price, Fire Marshal Mark Pitts and EMS Manager Joe Belanger, "the likelihood of survival in the South Zone is dismal." The Burke EMS officers worked with fire department chiefs Alan Hudson of South Mountains, Scotty Godfrey of Enola and Michael Martin of George Hildebran. Price said, "We all agreed that, initially, we needed to look at an experimental program, so that we could move the base ... and tweak the hours and operation as necessary." There were -- and are -- problems to overcome. Finding a suitable location was one; finding personnel was another. The Ruritans helped solve the first problem by offering their facility as a temporary home. Staffing isn't as simple. "As we discussed this issue," Price told the commissioners, "it became apparent that none of the individual departments could provide drivers and likely there would be times when none of the three would have personnel." The necessary personnel must be certified medical responders at a minimum. Price said he hopes to recruit suitable drivers by offering a stipend, similar to what Burke County EMS does at its Jonas Ridge base in northern Burke County.

To provide an on-duty paramedic at the new base, Price said he expects to recruit an experienced one from one of the central bases -- Burke EMS also operates bases in Glen Alpine, Hildebran, Morganton and Rutherford College as well as Jonas Ridge -- and to replace that person with a temporary hire. Billing and record keeping for the new base may be helped by the department's billing agency and Blue Ridge HealthCare, each of which offered to pick up half the $12,000 cost for software. Price proposed operating the South Zone base for five months, starting in January, and coming back to the county commissioners in June with a recommendation.

To open the temporary base, Price presented two options: one with a paramedic and driver available 12 hours a day; the other for 24-hour coverage. The first will cost about $84,000 for five months; the latter, nearly $114,000. The expense isn't in the county's' budget, so the money will have to come from its fund balance. Commissioner Gene Huffman, who lives midway between the Enola and George Hildebran fire stations, enthusiastically moved to adopt the more-expensive Burke EMS proposal. Other commissioners were more cautious. They finally agreed to fund the less-expensive option, but asked Price to come back in January with costs for providing 24-hour coverage on the three days (Sundays, Tuesdays and Fridays) when EMS receives the most calls from the southern area. Commissioner Ruth Ann Suttle also noted that the board has heard many appeals for a Burke EMS base in the Lake James area. Price said he will return to the board next spring with a detailed recommendation for a Lake James-area base.


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