Top 10 stories of 2012 — No. 9: Town-based paramedics rejected

Post 53 responds to the scene of an accident in May 2012.

The discussion over Darien-based paramedics has continued through another year despite a decision from the EMS Review Committee that the addition would be unnecessary.

In a report to the Board of Selectman in April, the EMS Review Committee shared its decision based on a year’s worth of data, which placed Darien EMS-Post 53 on the scene within six and eight minutes of a 911 call. Paramedic response was between eight and 12 minutes with immediate dispatch, though the time increased to between eight and 21 minutes if paramedics were requested after Post 53 arrived.

The response from dispatch was “within acceptable criteria” and “below national averages,” according to the report. The committee did question “scene-initiated” calls for paramedics because these had the slowest responses.

Paramedics generally arrived faster to neighborhoods in Western Darien, which is closest to Stamford. Likewise, the response was slowest to northeastern and southeastern areas. Scene-initiated paramedics made up 22-25% of all paramedic response, according to the report.

The committee’s decision was also based on the observation that Darien had a “low overall number of calls” which could “jeopardize the provider’s ability to maintain the skill required of a full-time paramedic.”

The committee was originally formed back in 2009 to look at the town’s emergency services in response to an Advisory Board of Health’s suggestion that paramedics may be beneficial. In 2010, Post 53 started using C-MED as a dispatch service, which immediately sends a police officer trained in CPR and defibrillation, and subsequently Post 53 EMT’s trained in basic life support services. If paramedics are necessary, the closest available ones drive in from Stamford and sometimes from Norwalk.

The decision not to hire town-based paramedics continues to be discussed because EMS response times vary based on a resident’s location in town.

One recognizable figure in the discussion is Walter Casey, a Darien resident who has posed many questions about the validity of the committee’s review and Post 53’s actions. Casey’s letters, some of which he sent directly to RTM representatives, consistently appear in the Darien Times’ editorial section.

His views, generally, were that current EMS response times to patients outside of the center of town are not OK. Casey has also criticized the fact that Post 53 cannot administer advanced care, like medication through an IV drip, use intubation, or give advanced cardiac life support.

Ron Hammer, Post 53 director, has stated that most of the pre-hospital IV medication necessary is for pain management.

In addition, Casey’s letters speculated that the three or four minute discrepancy between dispatching paramedics immediately and waiting for Post 53 to assess the situation could mean life or death to a patient.

Casey brought up points he perceived as preventing the town’s introduction of paramedics including Post 53’s elitism and desire for control. One letter, on November 29, directed questions to Ron Hammer.

“If you recognize the need for paramedics, why do you not support basing paramedics in Darien which would greatly reduce response times?” he wrote. “Is the rejection of Darien based paramedics due to paramedic versus EMT authority protocols, i.e. control?” he wrote.

It is up to the town to hire a paramedic, said Hammer, whose response was generally muted this year until the Darien Times published his opinion on December 20. “We support basing paramedics wherever the Town wants to put them,” he said. Hammer also stated that Casey’s allegations that the teens who volunteer and train for Post 53 do so for a better resume are untrue.

“These are people who are dedicated to the service of others,” he said. “Many of our members volunteer more than 100 hours per month to help our community.”

Since the decision in April, the committee was reduced from seven to three members with instruction to meet regularly and at least once a year. The committee should continue to analyze Darien’s emergency services, including the details of scene-initiated calls as per its own suggestion.

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