Dec. 28, 2001

Paramedics are still a top priority

As a paramedic working in a town not licensed to provide paramedic service, Firefighter David Emswiler often struggles with the limits on his ability to provide medical care.

"It’s frustrating," he said. "I know what the patient needs but I can’t give it to them."

Emswiler is the only Walpole firefighter licensed as both a paramedic and an EMT.

As an EMT Emswiler is able to perform basic lifesaving functions such as administering oxygen, bandaging a wound and performing CPR. He can also perform basic functions on a cardiac defibrillator. Most Walpole firefighters are cross trained as EMTs.

As a paramedic Emswiler can perform more advanced functions such as starting an IV, administering medication and intubating a patient.

He can’t use any of those skills when on the job in Walpole, however.

With the town lacking a paramedic license, Emswiler is forced to stick to the skills he learned as an EMT.

Walpole is one of a diminishing number of area communities that does not provide its own town-run paramedic service.

The service is provided instead by paramedics from Caritas Norwood Hospital.

While Walpole’s Firefighters/EMTs are the first ones to respond to any emergency, if a patient requires paramedic care he or she must wait for a crew from Caritas to arrive.

Emswiler, who also serves as the fire department’s director of emergency medical services, is looking to change all that.

He and Fire Chief Edward Hartmann are hoping that the town will give the department what it needs to get a license from the state: a staff of eight full time paramedics.

Although creating eight new positions may seem like a daunting task, the department is not exactly starting from scratch.

Emswiler is already on board, and a $3.7 million override passed earlier in the fall provided enough funding for the town to hire four new firefighter/ paramedics.

Once those five paramedics are in place, the department may be able to get a temporary waiver from the state to start providing more advanced medical care, but only if a plan is in place to bring the staff total up to eight.

That means that the department still needs to secure funding for at least three more firefighter/ paramedics.

Hartmann, who will ask selectmen to fund those positions in the new fiscal year, explained in a recent interview why a town-run service is so important.

With the town’s population expanding and aging, the department is responding to an increasing number of medical calls, he said.

Since the Caritas paramedics are stationed in Norwood and serve other communities besides Walpole, it can often take them a long time to respond to an emergency, he said.

Noting that paramedics are able to perform treatments that could literally mean the difference between life and death, Hartmann said that residents have the right to get the best possible care from their response team.

Another benefit of a town-run service is the additional revenue that the town will receive from providing paramedic care.

Ambulance fees are the second highest source of revenue for the town.

Since paramedic care is billed at a higher rate than EMT care, the town loses a great deal of potential revenue to Caritas each year, he said.

In 1999, for example, the town lost $300,000 in potential revenue to Caritas.

Hartmann said that he believed a town-run paramedic service would eventually pay for itself.

The chief also said that with more and more towns providing their own paramedic service, private services like Caritas aren’t going to be around forever.

"The handwriting is on the wall," he said.

In order to reach his goal of eight, the easiest thing to do would be to hire individuals that are already licensed as paramedics, he said..

Working and training at the same time "is a major commitment on the part of the firefighter," he explained.

Emswiler knows this from experience.

It took him a full year to get his license. During that time he attended classes three days a week, spent 4000 observation hours at the hospital, and went on numerous ride alongs with other paramedics in the field.

Emswiler also sacrificed a number of his personal and vacation days to free up time for the course, and had to pay the tuition costs up front. The town reimbursed his tuition costs after he completed the course.

Though hiring licensed paramedics is preferable, the chief said that the application pool isn’t as deep as he’d like it to be.

For example, towns like Foxboro and Sharon that have recently upgraded to paramedic service took away a lot of the candidates that could have potentially ended up in Walpole.

Of the 32 individuals hoping to fill the four new positions, only 16 passed the department’s application test, Hartmann said.

Many of those who failed were paramedics, he said.

And while the department wants to upgrade its level of emergency care, it doesn’t want to do so at the expense of its ability to fight fires.

"You always want to hire the best overall candidate," Hartmann said.

Copyright 2007 The Walpole Times