Emergency medical response under the Department of Defense
For the most part, providing EMS in the Navy is the same as in most civilian agencies. “We have many of the same issues on base that we do off base,” says Terry R. Anderson, EMS chief officer for Navy Region Northwest (NRNW) Fire and Emergency Services. However, there are a couple of differences in operations when you work for the Department of Defense.
Anderson is a civilian chief in charge of EMS for the Navy Region Northwest, an operation that coordinates base providing support functions throughout the six-state area of Washington, Oregon, Idaho, Alaska, Montana and Wyoming. He is based in Keyport, Wash., on the Puget Sound, south of Seattle. Previously, he worked for Mason County (Wash.) Medic One.
“One of my goals is to have the best patient treatment and care possible,” he says. “It’s always been my goal as a paramedic.”
Medical direction for all naval bases is covered by region. There are seven within the U.S., plus Europe, Japan and the Marianas, for a total of 10 regions. An overall medical program director (MPD) currently works from San Diego. The Navy Installations Command (CNIC) provides funding, guidance and oversight for the naval fire departments.
At this point in time, all fire departments on U.S. Naval bases are staffed by civilians. Larger bases maintain staffed stations. Smaller bases rely on mutual aid, although they may have some Navy firefighters they can deploy. According to Anderson, the Navy Region Northwest has staffed stations only in the state of Washington, which means personnel must obtain and maintain a Washington state EMT card.
The command structure is similar to that of most civilian departments. It includes a fire chief, with a deputy fire chief and assistant chiefs of operations, training, prevention and EMS. The EMS program is led by the regional EMS chief–Anderson, in the Northwest Region–assisted by a program director for each battalion.
“It’s interesting to [work in] a civilian world on a federal installation,” Anderson admits.
Navy training issues are unique. The CNIC has oversight of all training. However, individual base chiefs, like Anderson, must find ways to integrate local training into the national CNIC. In Washington, for example, Anderson uses an online, ongoing training and evaluation program (OTEP), something that is outside the national CNIC norm. “The Navy is very strict on training issues,” Anderson says.
Mutual aid with other fire agencies and districts is a particularly tricky issue for Navy EMS responders. Because military bases are federal installations, they have their own regulations. These regulations are sometimes in conflict with state regulations. “To have a good working system, you have to work with partners outside the installation to make sure there’s no conflict,” Anderson says. He spends a good deal of time building those relationships so that when navy EMS personnel respond on mutual aid to neighboring communities, they are just as effective and efficient off base as they are on base.
Conversely, neighboring agencies need to be educated about the special procedures required, particularly security procedures, when they respond on base. “Our job is to avoid any delays in patient care,” Anderson says.
To help address challenges specific to EMS in the Navy, an EMS Advisory Board has been established. It meets a minimum of twice a year to make recommendations to the fire chiefs in charge of naval bases worldwide. It consists of representatives from each of the 10 regions. One meeting is face to face, usually in conjunction with the annual International Association of Fire Chiefs EMS Section Conference. Because of the distances involved, other meetings are accomplished via teleconferencing. “We are always fully aware of our obligation to the taxpayers,” Anderson says.
At the May meeting, the Advisory Board discussed issues regarding protocols for bases that have none. According to Anderson, the group finalized the protocols it has spent the past year developing. The medical program directors will review the recommendations, sending the changes back to the board for formatting before the protocols will be released.
At home, Anderson has spent the past three years consolidating protocols for the bases within his region. “When I first stepped in, they had five separate MPDs and five separate sets of protocols,” he says. If someone went from the Bremerton base to the Everett base to work–a two-hour drive–they had to be aware of the differences.
Anderson worked with state officials and the military to create a single entity with one MPD and one set of protocols, saving a significant amount of money on MPD fees, training, non-consumable products and expectations.
To further cut costs, he is working to standardize the equipment on all ambulances in the region. “We face the same budget cuts as the civilians. Money gets tighter and tighter,” Anderson says.
That’s one thing, Anderson says, that really is the same.
