Questions & Answers

Floyd County Rescue Q&A

(Floyd County citizens often ask rescue squad members about their operations. This monthly column is an effort to publicly answer such questions. If there’s something you’d like to know, please send your questions to: Q& As mandated by courtesy and federal law, personal information about patients and squad members will not be discussed, but from all other questions we’ll select one or more each month to appear in this column.)

When to Call 9-1-1?
How Fast Can Ambulances Go?
Why Volunteer?
Does Ambulance Arrive Sooner?
What Takes So Long to Arrive?

Q – When should I call 911 for medical assistance?

A –Without the diagnostic resources of a hospital, we generally accept at face value what we’re told and take the appropriate actions called for in our protocols and standing orders. We always try to do what we believe is in the patient’s best medical interest.

But, Floyd County Rescue is an emergency medical service and because our resources are limited (only a few EMTs to provide 24 hour coverage every day), calls to 911 should be reserved for potentially life-threatening emergency situations requiring immediate transport to the nearest appropriate medical emergency room. As a state certified EMS agency, we provide pre-hospital care and transport only to hospital emergency departments. We are prohibited from transporting patients for direct admission to a hospital or to a doctor’s office for treatment

Why are we concerned? There are a couple of reasons. One is that we often have only one ambulance team on duty and a single trip to a hospital requires two to three hours to complete. Another is that our protocols require that we remain with the first patient to whom we’ve been dispatched until that patient signs a refusal for transport or is delivered to the hospital, regardless of how serious future calls may be. If we are committed to a call for a non-emergency medical complaint, we are unable to respond to a potentially life threatening call for help. But that’s the way the system works.

So, questions we wish patients would ask themselves before calling 911 are:

* Do I believe my illness (or injury) is serious or even life-threatening. Should I be checked out by a doctor?
* If so, do I need to get there in a hurry?
* Will I need medical attention on the way to the hospital?

Some specific signs of potential emergencies that should be called into 911 include:

* Person unconscious or unresponsive.
* Motor vehicle crash resulting in injury.
* Fall resulting in serious injuries that may include head trauma and/or neck or back injury.
* Severe bleeding.
* Cardiac problems including chest pain.
* Possible stroke.
* Difficulty breathing
* Diabetic emergencies
* Allergic reaction

In such cases, please call 911.

If your problem is not this serious, but you’d still like to see the emergency room doctor, you might call a transport ambulance service or have a friend or relative drive you to the hospital, which will often take less time than waiting for an ambulance. An ambulance transport service listed in the Floyd telephone book is Carilion Patient Transportation Service at 1-888-377-7628.

But, remember, if it’s a medical emergency, call us as soon as possible.  We’ll get there as fast as we can.

Q – Just how fast can ambulances legally go?

A – The law doesn’t set a limit by speed. Virginia Code §46.2-920 says only that emergency vehicles in emergency conditions may disregard speed limits “while having due regard for safety of persons and property.”

In fact, the law also says, “Nothing in this section shall release the operator (ambulance driver) of any such vehicle from civil liability for failure to use reasonable care in such operation.”

Or, as one of my Emergency Vehicle Operator Course (EVOC) instructors once said, “you can go just as fast as it takes for the patient’s well being, so long as you do it safely.

In this same vein, Virginia law spells out a number of traffic laws that may be disregarded by emergency vehicles (fire, rescue, law enforcement and others operating in the performance of public services).  In all cases those responding to emergency situations must do so “with due regard to the safety of persons or property.”

Besides speed, among other traffic laws that may be disregarded include:
* Proceeding past flashing red signals, traffic lights, stop signs;
* Passing or overtaking stopped or slow-moving vehicles by going to the left either in a no-passing zone or by crossing the highway centerline. They may also pass on the right off the pavement or main road without flashing lights and sirens.
* Pass or overtake another vehicle at an intersection

In most cases where traffic laws can be disregarded, Virginia code does require that emergency vehicles display flashing, blinking or alternating lights and sound a siren or other sound device “designed to give automatically intermittent signals.”

All fire and rescue vehicle operators in Virginia must periodically pass a comprehensive EVOC written and driving exam and be certified before they can drive fire and rescue vehicles.

Q – Volunteers are often asked, “Why do people volunteer to serve on the rescue squad? What makes all the time, effort and commitment worth it? Floyd County Rescue Squad members were asked this during their June 2007 business meeting. Here are some of their answers:

A —  “I joined the rescue squad after I witnessed a horrific car crash. I could only watch and wait ‘til an ambulance arrived. I felt that the rescue workers did an excellent job taking care of the young man. The next day, I called the rescue squad about joining so that I wouldn’t feel so helpless the next emergency I came upon. I stay on the rescue squad because of the patients I meet and the experience that goes along with being on the rescue squad.” – Megan Gates

A – “I volunteer because a volunteer once touched my life and saved me when I was a child. Ever since, I wanted to be an EMT and be able to touch someone else’s life in a positive way. All the time, effort and commitment are worth it because we all become an extended family and take care of one another, our community and anyone in need. I get such personal satisfaction knowing I can give to someone and bring some comfort when fear and emotions are running high.” — Amelia Stevens

A — “I felt that it was a calling for me. It is a way for me to give back to Floyd County the appreciation I have for the acceptance Floyd people gave me when I moved into the county several years ago. It’s always worth the time, effort and commitment to help someone have a better life.” – Dale Bowman

A – “The rescue squad becomes more than just a squad. The squad becomes a second family and all the patients become part of that family. A volunteer squad becomes the heart and soul of a community. A ‘thank you’ to a volunteer makes the commitment worthwhile. What makes it even more worthwhile is when a patient thanks a volunteer’s significant other or family for the volunteer’s dedication to helping others. When running calls, a member sees a lot of things to be thankful for. For me, one thing I’m thankful for is being able to watch a child that I delivered grow up. He has just turned three.” – Jason Schumann

A –  “I joined the squad because I decided I could help in some way with the care giving of someone in need. I get a good feeling when I can make a difference.” – Darel Quesenberry

A – “I’ve really enjoyed meeting neighbors that I would not otherwise have met. In fact, I estimate that I have more than a hundred Floyd County friends that would not have met except for the rescue squad. I really enjoy being able to help others in need and the rescue squad makes that possible. I thank the Lord and FCRS for giving me the skills and training needed to meet the challenges presented by emergency medicine. I’m able to do this because God gives me the
strength and Floyd Rescue provides the training.” – Nathaniel Sommers

A – “Why do I do it? At 3 a.m., when the weather is bad, when I am tired, when the call doesn’t sound like a true emergency, I may ask myself that question. Then, when a call comes and I respond to find a true emergency, I instinctively fall back on my training, I do what I know I need to do, and it makes a difference. Someone gets to the hospital in time. Pain is relieved. Further injury is prevented. A life is saved. And I played a small part in bringing that about. That’s a feeling many people would pay a lot for – and it’s not for sale.”  — Donna Johnson

A – “When you run a call and that person looks at you with tears in their eyes and says, ‘Thank You,’ that’s all you need to make it worthwhile,” – Janice Cox

Q – Does a patient arriving by ambulance receive quicker service than a patient arriving by POV?

A — “No,” says Joyce Yearout, director of the emergency department at Carilion New River Valley Medical Center and Carilion Giles Medical Hospital. According to Joyce, this is how it works.

All patients arriving at the emergency room are given a medical screening and triage upon arrival to find out what their medical problem is and to determine how serious it is. This is then compared to that of other patients and care is provided accordingly. One exception is that trauma patients and those with potentially life threatening illnesses are generally given care first.

She also said that on occasion patients arriving by ambulance are taken to the waiting room and at times patients arriving by private automobile are given care first, based on their medical needs and that of others.

Q – Why does it take so long for an ambulance to arrive after we call 9-1-1?

A – Many injuries and illnesses may be life threatening, so it’s truly important that we get such people to a hospital as quickly as possible. Unfortunately, Floyd County is so large, we volunteers are so few and money is so illusive, that it often takes more time than we like for us to arrive at some patient’s locations.

Why?  There are more than 14,800 people living in Floyd County spread across its 383 square mile area. There are 28 active Emergency Medical Technician (EMT) volunteer members of Floyd County Rescue Squad working out of the three stations where our ambulances are located.

Traditionally, when we’re toned out for an emergency, volunteer members who can, travel from where they are to the nearest rescue station. There they may have to wait until there is at least a certified emergency vehicle driver and an EMT, before they can leave for the scene, which can be a considerable distance away.

Your volunteers, in cooperation with Floyd County officials, have taken action to reduce the length of time necessary to get patients to more definitive medical care.

The county, for example, has created a Emergency Medical Service unit that provides advanced life support certified EMTs on a 24-hour, seven-day basis. This ensures that the county has such help available when needed – at least for the first person to call 9-1-1. Volunteers, or ALS providers requested from nearby counties under mutual aid agreements, must take additional calls until the County EMS technician is returned to service.

The county also provides a two-person basic EMT ambulance crew between 6 a.m. and 4 p.m. weekdays when so many volunteers are at work.

Q — What about volunteers?

Since the squad’s creation, when rescue calls are dispatched, members located in the patient’s area who are available, respond directly to the scene in their personal vehicles. There, they do what they can until an ambulance arrives.

In recent months, to improve weekend daytime coverage, members have been signing up for six-hour standby shifts at Station 1 (it’s centrally located in the county) between 6 a.m. and 6 p.m. each Saturday and Sunday. While this is a significant disruption in the volunteers’ weekends, it has speeded up the response time.

Unfortunately, Floyd County Rescue Squad will probably never be able to recruit enough volunteers, buy and stock enough ambulances or build enough stations to dramatically reduce the response time, but we will keep trying.