News

Texas Fire Department, EMS Agency Reach Agreement on Medical Care

James Draper

02/10/2016

Feb. 10--Previously, in those instances when Kilgore firefighters reached the scene of a medical emergency first, there was only so much they could do, a cap on the care they could provide until Champion EMS personnel arrived.

Come next week, after more than a year of negotiations and restructuring, the gap will close significantly.

The debate about the possibility of local 'fire-based EMS' came to a head in the summer and early fall of 2014. Kilgore Fire Department officials unveiled their proposal to go it alone on emergency care inside the Kilgore City Limits. Unsurprisingly, Champion EMS resisted the change to its long-standing contract with the City of Kilgore.

In the end, with many perspectives pushing the debate to a stalemate that autumn, the two operations went back to the drawing board.

The past eight months, in particular, have seen progress: beginning Monday, firefighters with EMT training will -- to a certain extent, broadly expanded -- be permitted to utilize their skills in the field under the direction of Champion EMS' top doc.

"What we want is a continuum of care that is smooth and seamless," Kilgore Assistant Fire Chief Mike Simmons said Monday. "From the time you call 911, each level of care is continuous."

Effectively, by lifting previous restrictions, when firefighters arrive on scene first they'll be able to work in a way similar to their counterparts aboard Champion's ambulances. It could mean earlier treatment and an easier hand-off, no delay in care nor any interruption in signing over a patient.

"It just gives us a lot more capabilities on the medical side to assist in the treatment of our citizens," Simmons explained Monday.

It's a new model for Champion EMS, according to Dr. Chris Dunnahoo, medical director for the Longview-based operation.

It will be a different setup from the vast majority of the 50-plus organizations that fall under the company's medical direction. Unlike Kilgore, most are smaller communities, many of them with volunteer departments. Those operations will remain limited to First Responder efforts for the foreseeable future.

"It was really Kilgore fire's interest in trying to provide some kind of an increased skill set for their firefighters to be able to provide to the citizens that kind of prompted us going down this path," Dunnahoo confirmed. The short distance between Champion's Longview base and Kilgore facilitates the new setup. "This is a brand new thing for Champion EMS to do.

"I think we're going to be learning as we go along. I'm excited about the future. I think this is going to be a win-win for everybody involved."

Previously, Kilgore firefighters -- regardless of their level of training -- were restricted to administering a more basic level of care under 'First Responder' protocols.

"Under the new system we will be able to actively participate or practice enhanced skills" when necessary, Simmons explained, before handing a patient's care over to Champion EMS personnel for transport.

Among KFD personnel with some level of Emergency Medical Technician certification -- about 35 firefighters -- two dozen are at least EMT-Basic: trained, for example, in enhanced First Aid and cardiopulmonary resuscitation, capable of assisting patients in taking prescribed medication and approved to performed limited procedures on airways. Another three have 'Intermediate' certification as EMTs and an additional six are paramedics.

The new protocols initially increase firefighters' approved level of care to certain aspects of the EMT-Intermediate level, Dunnahoo confirmed, putting their existing training to use.

"It is a significant bump from what they were," he explained, permitting the local personnel to administer certain medications, perform enhanced procedures and, for example, start an IV: "To allow them to utilize the skills that they worked so hard for and in essence to work together as two organizations to provide better care to the citizens of Kilgore."

Since the peak of the fire-based EMS debate in Fall 2014, negotiations between KFD and Champion EMS have funneled into developing procedures to integrate the fire department's efforts into the Emergency Medical Service's.

According to Dunnahoo, his own mindset has evolved in the past year, and he perceives the same attitude in both agencies.

"A change in the mindset of how we can work together through both organizations in order to create better patient care," he explained. "It's really the idea of teamwork, working together, working side-by-side -- this smooth transition when everybody's on scene."

In a year, Simmons hopes, protocols will be expanded even more.

In the meantime, "We're making a serious enhancement in using our skills and capabilities," he said, with excitement on both sides. "Both organizations are going to be able to benefit."

The end result, Kilgore Fire Chief Johnny Bellows said, is better care for Kilgore residents.

He's grateful to Dunnahoo for taking KFD more fully his umbrella as medical director, to Champion EMS for developing the pilot program with Kilgore firefighters.

"It takes a lot on his part to allow this to happen," Bellows said. "It's their first one so that makes me even a little more proud that they have the faith and the confidence in the Kilgore firefighters that they will be able to pull this off and do this well."

Each initial level of care firefighters can provide could mean a big difference depending on the situation: "It's just something that could possibly save a life."