Director pushes to improve medical dispatch

By Thomas Wilson
STAR STAFF
twilson@starhq.com

   The county's medical director says improving the county's emergency medical dispatch is paramount to keeping emergency medical care at its highest level - a demand involving something the district is struggling to find - money.
   "This is something we have to do," Dr. Vance Shaw, the county's medical director, told the 9-1-1 Communications District's board of directors on Tuesday. "Our emergency medical dispatch is not adequate."
   Shaw explained Emergency Medical Dispatching (EMD) is a nationally standardized system whereby dispatchers can assist callers with medical help to victims while waiting for paramedics to arrive on scene. Making EMD work involved educating the dispatchers, following standardized protocols and a quality control mechanism, Shaw said.
   Before the modern era of emergency medical service, civilians injured in accidents were put inside the back of a pickup truck and driven to the nearest hospital for treatment, Shaw said. Now, emergency medical treatment has become a growing responsibility of 911 dispatchers who often are the only outside link victims have to help until paramedics reach them.
   Shaw has served as medical director for several years and said he is willing to take on quality control to maintain the EMD system. The first step would require hiring a full-time employee to maintain quality control of incoming calls.
   He urged the board to adopt quality control standards for emergency medical dispatch and to add himself to the board to have input in management decisions pertaining to the district.
   "We've got to be able to have the recording system we need," Shaw said. The board had considered purchasing a digital system to record incoming emergency 911 calls. The system could hold 30 days of incoming calls on one disc. The district currently uses VHS tape to record incoming calls, dispatcher responses and public safety personnel arrivals.
   Board chairman Roger Deal emphasized the need for digital recording of 911 calls earlier in the meeting. "We need to come up with a plan or we are going to be hurting," said Deal.
   To serve as an emergency medical dispatcher, a three-hour course and certification is required.
   "If you are going to have medical dispatch ... you need to have the personnel and the equipment," said Glenna Morton, interim director of the District.
   Board members also noted that in the day of lean budgets, implementing Shaw's plan would be a challenge. Morton estimated the district's budget for the 2004 fiscal year would be $22,000 short. "Where is the money going to come from?" board member Bill Carter asked.
   One possible funding mechanism previously discussed by the board is petitioning the Tennessee Emergency Communications Board (TECB) for an increase of telephone or cellular surcharges to customers. Morton said the District would be required to submit a request to the TECB and hold a public hearing explaining why the surcharge was necessary.
     Presently, the 9-1-1 District sets a service surcharge of 65 cents for residential and $2 for business customers billed through Sprint telephone service bills. "That board can approve or disapprove the rate increase," Morton said.
   The board also welcomed a representative assigned to fill in on behalf of a sitting member. In a letter to the board, Sheriff John Henson advised the board he had appointed Thomas Bowers as his representative to act in his absence and with his authorization. A captain in the Elizabethton Police Department, Bowers serves as the city's code enforcement officer and also represents the 4th District on the Carter County Commission.
   In other business, the board unanimously selected John Piercy as its new chairman effective July 1. Deal had been appointed to serve out the two-year term of Elizabethton Fire Chief Mike Shouse who stepped down as chairman earlier this year.