EMS board discusses legal, logistic hurdles

With the summer coming and the potential for more patients calling for ambulances or needing transport out of the county for medical care, the Lincoln County EMS Advisory Board met Tuesday to continue their efforts toward cooperative solutions.

Mark Harding, a physician at Cabinet Peaks Medical Center, said he is worried for the coming summer, due to the rise in patients it brings and the limited EMS staff on duty.

“If somebody’s dying, that’s an understood thing that I’m supposed to help,” he said.

Harding wants people in the hospital realm to be able to help the understaffed volunteer ambulance services when necessary. But Harding is unsure if it can happen because of the legal gray areas posed by hospital staff working in ambulances.

He said he fears that without an increase to the ambulance staff, issues will become worse over time.

Jeff Holder, president of the Libby Volunteer Ambulance Service, said he tried to get an answer from the state regarding whether he could have the hospital staff put on the EMT call list. He only received “very grey dancing around the subject” answers.

Staffing on summer weekends is the hardest because people like to go out on trips, he said. It would be great to have another driver on-call in Libby. Sometimes no calls come in and other times the crew gets swamped.

On transports, the ambulances have had nurses from the hospital and respirators on board, but he still does not know if it is legal, he said.

Penny Kyes, an office manager and volunteer at the Libby Volunteer Ambulance Service, said liability between the ambulance and hospital office becomes the issues. When they are both working in the same place it becomes hard to know who should be insured.

“It kinda gets really sticky,” she said.

County Commissioner Jerry Bennet said both parties should have a memorandum of understanding to make working together legally easier.

There should be a basic understanding of liabilities in a simple document, he said. “We’ve become encapsulated with all of the regulation.”

The board also discussed the possibility of funding an extra CPR machine for ambulances or borrowing one from Cabinet Peaks if it ever became needed.

A CPR machine — sometimes called a “thumper” — fits around a patient and does chest compressions, freeing up first responders to provide care to the patient.

Holder said he wants ambulance staff to have an extra CPR machine. That way, if the first truck with the CPR machine is gone and the second truck is responding to someone who needs extended CPR, they will be prepared, he said.

Doing it by hand is definitely not ideal, he said. “Three blocks is a long way to do CPR.”

Additional machines are normally kept in the hospital’s ER. Each costs about $30,000 and the ambulance crew has a lot of other stuff to pay for, he said.

Holder suggested borrowing the hospital’s CPR machine.

Bruce Whitfield, CEO of Cabinet Peaks Medical Center, responded that he is unsure if the hospital staff could help. He would have to check with physicians at the hospital to see if they would ever be able to lend their CPR machines.

The board members did not reach a final agreement on the CPR machine question.

Bennet said if they want changes they need to turn the talk into action.

“Even if we only accomplish one thing out of each meeting, I think it moves us forward,” he said.