JEMS.com Editor’s Note: A. J. Heightman comments on “Does a Richland Co. EMS policy contribute to patients’ deaths?” that appeared on JEMS.com April 25, 2008.

Imagine you are a first responder from a municipal fire department. Can you imagine being forced to stand by at the scene of a drowning and watch a county EMS crew wait on scene an additional 20 minutes for another county EMS crew to arrive to provide them with a driver to allow the first crew to perform their “life saving skills” in the patient compartment?

It’s a situation I can’t imagine existing in 2008. As a paramedic, well aware of the need for two providers to render care to cardiac arrest victims, I’m appalled at the policy and attitudes presented by Richland County (S.C.) EMS.

I commend the Columbia firefighters for their exercise of restraint while being forced to stand by and watch needless and, in my opinion, potentially negligent delays, in patient care. If I was one of the fire department responders at the scene of the child drowning case, I’d have to be restrained from intubating the crew chief with a Haligan bar and transporting the child with CPR in the cab of the nearby engine.

Waiting on scene to obtain a qualified driver is a weak excuse to try to justify delays patient care. If George Rice and the other administrators at Richland County EMS truly had the best interests of their patients in mind, they would hold special training immediately for all Columbia Fire Department personnel to give what they call “formal training to know how to communicate with paramedics in the back.”

I’ve worked in EMS for 30 years and had firefighters and police officers drive my units to the hospital hundreds of times in a professional and safe manner without any untoward incidents occurring.

I’ve also had firefighters and police officers assist me in the patient compartment on ALS calls while my partner drove to the hospital. You don’t always need a second paramedic to bag, suction or compress a patient.

Driving the rig was never the problem; anyone can be rapidly coached to drive slowly, brake softly and call out sudden stops and turns. It’s familiarizing the “substitute” drivers with the location of emergency light and siren switch locations that requires some (about 10 seconds) instruction.

Richland County EMS may be able to dodge the negligence bullet with medical cases that require continuous ALS skills, medications and electrical therapy while in transit, but they will drain the county’s finances when they try to defend their antiquated delay-for-a-driver policy with a trauma victim bleeding out from a leaking spleen, or a patient in shock and going down hill as a result of thoracic aneurism. When this occurs, I’m sure a few Columbia FD personnel won’t mind waiting 20 minutes to testify on subpoena from a deceased patient’s family.