MILWAUKEE, Wis.– In one fell swoop, by juggling city funds this year and counting on voters to approve future tax increases New Berlin, Wis., is about to upgrade its rescue services to rival that of larger urban areas.
If the 2008 municipal budget, tentatively adopted last week by city officials, is finalized, the city will dramatically increase the number of full-time paramedics in its Fire Department.
Fire officials believe this reflects the public s expectation to have top-level emergency responders with paramedic certification.
But the rapid evolution for a department that just six years ago was a rural-type, privately run force has surprised at least one observer of fire department trends in the state.
In addition, the outspoken enthusiasm for paramedics has offended other rescue personnel, such as emergency medical technicians, who bristle at suggestions that EMTs offer substandard care that is little more than a fast ride to a hospital.
The Fire Department persuaded aldermen to include about $664,000 in next year s budget to hire 19 full-time paramedics by the end of 2008. The department currently has eight full-time paramedics who also work as fire inspectors.
In addition, two of the department s four assistant chiefs are certified as paramedics, as are a handful of its roughly 80 part-time, paid-on-call firefighters.
A public hearing on the budget is set for Nov. 20. Voters will likely be asked as soon as February to approve further tax levy increases to continue to fund the paramedic program.
Having 27 full-time paramedics will allow the department to provide 24-hour coverage at two of its five fire stations, said Fire Chief Edward Dobernig.
The department, which was taken over by the city in 2001, began phasing in paramedic service in 2006. It must provide 24-hour coverage by August 2008 to be licensed by the state as a paramedic-level service provider.
In pushing for city support, Assistant Chief of Operations Thomas Dobernig, who is the chief s brother, distributed an e-mail recently to city officials, residents and the news media in which he said, Although paramedic service has been the standard of care in much of the area and around the country since 1973, the City of New Berlin has provided little more than Basic Life Support until August of 2006.
In an interview, Dobernig said; Basic life support is just that. It s basic; it s CPR. We re not administering cardiac medications to correct arrhythmias; we re not administering pain medications to manage a person s pain; we re not defibrillating anybody. With basic life support, you don t get any of that. You get, Let s check your vitals, put you in some oxygen and run you to the hospital.
Backing for EMTs
But Don Hunjadi, executive director of the Wisconsin EMS Association, says New Berlin fire officials owe the EMT basics in the state a huge apology.
Don t get me wrong. I completely support and advocate that New Berlin should be at the paramedic level, said Hunjadi. But to say that anything but that is just substandard, or that anything but that is just a fast ride to the hospital is just not true. While paramedics may be able to do more things, there s a lot of life-saving skills that an EMT basic can supply. Somebody having a huge, anaphylactic reaction to a bee sting or something they ate can have their life saved by an EMT basic. Someone having cardiac arrest can have their life saved by an EMT basic.
Hunjadi is surprised that New Berlin, with a population of about 38,600, doesn t think it can provide 24-hour coverage with its existing eight full-time paramedics and two other certified paramedics.
I d like to see what in the heck they re going to do with all those other people, he said.
It ultimately goes back to what a community wants and is willing to pay for, said Mukwonago Fire Chief Jeff Rolfe, whose department added paramedics about four years ago. His department has 10 paramedics — three full time and seven who are paid on call. Rolfe said he is trained in basic EMT skills but, having watched paramedics in action, doesn t take offense at suggestions that paramedics offer better care.
Our citizens now expect paramedics to show up, he said.
Dobernig said New Berlin s population is still growing, and noted that the city spans more than 36 square miles. West Allis covers about 11 square miles; Waukesha, 22 square miles.
Am I supposed to tell some people that because they live in one part of the city that it will take more minutes for paramedics to reach them? Dobernig asked. He also said his city has a large industrial park where industrial accidents might occur, and that his paramedics will double as firefighters.
In his e-mail, Dobernig also writes, Since August of last year, the New Berlin Fire Department Paramedic Program has documented 39 lives saved and treated 2,193 people. But Hunjadi doubts that could be proved. Is he saying all those people would have died if they had been served by EMTs?
Rolfe, Mukwonago s chief, said that realistically, many communities will continue to offer a variety of levels of emergency care and that not all emergency calls require paramedic services.
Public weighs in
At last week s New Berlin Common Council meeting, paramedic funding drew strong support from some residents.
Resident Maureen Siwula tearfully described how, many years ago, I called 911 to save my husband. Six police officers showed up at my door and no paramedics. Her husband survived, but she said she never again wants to call 911 without having a paramedic respond.But Jim Bauer, a resident who said he served with New Berlin s former volunteer fire department for 35 years, including 19 as an EMT, said, I find it very insulting that EMTs are now regarded as second class.