Safety & Service - October 3rd 2016

MINUTES OF THE SAFETY AND SERVICE COMMITTEE
Main Conference Room – Mayfield Village Civic Center
Monday, October 3, 2016 - 7:00 p.m.

The Safety and Service Committee met on Monday, October 3, 2016 in the Main Conference Room at the Mayfield Village Civic Center.  Chairman Marrie called the meeting to order at 7:00 p.m.

ROLL CALL: 

Present: Mr. Marrie, Mrs. Mills, and Mr. Jerome

Also Present: Mr. Williams, Mayor Bodnar, Mr. Wynne, Mr. Metzung, Chief Carcioppolo, Chief Edelman, Mr. Thomas, Ms. Wolgamuth, and Mrs. Betsa

FIRE DEPARTMENT:

  • Ambulatory Transport to Residents

Mr. Jerome requested that this item be placed this on the agenda this evening for discussion.

Mr. Jerome stated, I wanted to get some more information.  I know we talked about adding another full-time person to have a larger fire department and also I would like some more information about transport of residents.  I know other communities are able to transport residents further than where we are and I guess the biggest thing for us is the manpower issue.  I just wanted to get a little background on that and if we had more manpower, would we be able to do that?

Chief Carcioppolo stated, I don’t think the amount of manpower we would need to be able to get to that point would be worth it because we have the ability here on the east side to transport to any of the different hospital systems.  I guess there’s two different things you are talking about.  One is where we transport and the other is our staffing.  Our staffing I have been working on increasing because we have, in my estimation, been deficient for a long time so we have been doing that since 2013 and it’s definitely improving everything.  As far as our transport policy, it’s a liability to consider going, I guess you would have to say, what’s the limit to where you go?  Where do you think would be a reasonable distance to go?

Mr. Jerome replied, I guess anything on the east side would make sense.

Chief Carcioppolo stated, that’s really where our transport policy has been for the last 20-30 years, as long as I have been here.  I really can’t say it would be a good idea to change it because, and I will just use this as an example, I don’t totally understand the ambulatory transport verbiage of this, but if someone was not in an urgent manner and they needed to be transported somewhere, we are an emergency service.  We are not set up like a private ambulance company where we have 60-80 ambulances sitting in a big garage and ambulances staged all over Northeast Ohio to handle a call when it comes in from a hospital.  We have two.  There is a facet to it that involves manpower.  We are required by law to send two EMT’s on an ambulance, one driver and one patient care technician.  If we wanted to go outside of here, using Hillcrest or Ahuja as an example, if we can take them there, to transport people and deal with life threatening emergencies until we can pass them off to a doctor.  If we are going to prolong our transport time to go somewhere and pass those two hospitals, we really need a good reason why.

Also, we need to take into account that if we were to go past there what our lag time in returning is. Let’s say we go downtown.  That’s going to add an extra 30 minutes to our time from the time we drop the patient off to coming back than if we just dropped them off at Hillcrest or Ahuja and came back.  That time that we are gone, we just dropped our manpower by two people and we took another ambulance out of the city.  The people suffering are the people that are here, if they needed an ambulance.  For example, someone has a cardiac arrest and we were down there when we could have just taken them a few minutes down the street and we had to call mutual aid because there wasn’t enough people to staff an ambulance or whatever the circumstance may be.  That extra time for a mutual aid ambulance to come could be the different between a neurologically intact cardiac event survivor and a vegetable for lack of a better term.  When you look at it from a risk analysis point, there’s really nothing that outweighs bad risk when the people can be treated at any of these facilities on this side and stabilized and then transported somewhere else.

Mr. Jerome asked, how are the other communities able to do it?  They have larger manpower?

Chief Carcioppolo replied, that’s part of it.  Here, if we have four guys on duty and we have to take two to go, now we are down to two and if the patient is bad and the medic in the back wants someone else to help him, then we would be down to one guy here.  How do other places do it?  I don’t know.  I don’t necessarily agree with everyone.  That to me is a no-brainer.  If you are dealing with risk, that’s something you shouldn’t take a risk with when there’s all this ability to take care of stuff here if that makes sense.  Because other places do it, I don’t know that I necessarily agree with their policy choice.

Mr. Jerome stated, I wonder if more departments do than don’t.  I don’t know that.

Chief Carcioppolo stated, for example, Cleveland Heights.  They don’t take people out here just because they want to come out here because that adds to their return time to the station.  With how busy they are even though they have so many more guys, they are running 6,000 calls a year.  It doesn’t make sense for them to come out here.  That’s not to say that if there’s something they had to come out here for they wouldn’t, but they can do everything down there.  As far as everyone else goes, my main concern is everyone here, all the residents, the people at the businesses.  For us to have two squads and to send one a half hour away when we could do something locally doesn’t make any sense.

Mayor Bodnar asked, do our local hospitals have all of the levels of trauma care that we might need or are there instances that we would go somewhere else if it had a different level of trauma care?

Chief Carcioppolo replied, Hillcrest is a Level 2 Trauma Center.  UH Main Campus has just this year received their recognition as a Level 1 Trauma Center.  Metro has always been a Level 1 Trauma Center.  There’s not a huge difference between Level 1 and Level 2.  For us, taking someone to Level 2 is good because we are getting them somewhere where they have surgeons on staff, neurological orthopedic traumatologists and all these other people ready to deal with that.  We would have to make a decision on, for example, an accident on the freeway, if it is better to just wait and if they really need a Level 1, we will sometimes just say we are going to call a helicopter and Metro will come with their helicopter and take them right back to Metro’s Main Campus.  The Burn Center is Metro.  If we have someone with a really bad burn, we might elect to just take them to Metro because that is where they need to go or call the helicopter, but typically for a transport like that, if they are really bad we will just go to Hillcrest. So if there is a prolonged extrication or reason that we would need to, if we know that we are going to have a prolonged extrication, we might just elect to call a helicopter to come right away because we know that by the time we get them out of the vehicle, the helicopter will be there with a doctor and a nurse and that’s what we want, to be able to give someone care.

Mayor Bodnar asked, so the object is to get them the care they need as quickly as possible, not prolong the time?

Chief Carcioppolo replied, right.  Does that answer your question?

Mr. Jerome replied, yes, to a point.  It’s a matter of opinion and I can see where you are coming from. I can see where they are coming from.  How often is one ambulance out and you get a second call?

Chief Carcioppolo replied, I think last year we had 118 concurrent calls. I will try to pull it up real fast and let you know.

Mr. Jerome stated, but if we have a concurrent call, we don’t have three extra people so we can’t even go.

Chief Carcioppolo stated, it depends on how many people are on the first call.  There’s no real way to come up with how many times that would happen.

Mr. Jerome stated, you really can’t even do two calls at once if there’s three guys at the first one.

Chief Carcioppolo stated, if the first call’s not that bad, we will break off the chase car and the chase car will go meet the other person with the ambulance at the other call and then we will lock the chase car at the scene and go to the hospital so then we are on two calls.

Mr. Jerome stated, got it. So you can do it. You have done it.

Chief Carcioppolo stated, but if the patient in the first one is bad and three people go to the hospital, now we are down to one guy.  We respond, but we don’t have the ability to transport.

Mr. Jerome stated, so then we have to call mutual aid.

Chief Carcioppolo stated, we will meet the mutual aid company at the house and start doing patient care until they get there.

Chairman Marrie asked, how far do you want them to go?

Mr. Jerome stated, I know there is someone who has a specific doctor who wanted them down at UH Main Campus as opposed to Ahuja for whatever reason.  That’s why I wanted to try to get a little more information on it.

Chairman Marrie stated, I understand where you are coming from, but I don’t think you can honor every request because you would go much further. How far do you go?

Chief Carcioppolo stated, that really is part of where the question has to go, because if it’s by choice, one could say that.  But we are not set up for that.  We are not a private ambulance company that could send someone on a road trip.

Chairman Marrie stated, you are not Marten & Sons.

Chief Carcioppolo agreed.

Mr. Jerome stated, legally we are required to do our thing and bring you to the closest place.  We send them to the Hillcrest and they want UH and they die, that’s not on us.  We have done our job.

Chief Carcioppolo stated, I am sure you can find some argument in that wherever you want, but someone could say this person wanted me to go here.  At the end of the day, the primary role of a paramedic is to treat life-threatening emergencies and take you to some higher level of care so someone can do stuff that is going to fix you permanently.  We can do a lot of cool things and a lot of technical things that are very very impressive, but we are still just paramedics.  Our training is limited.  It’s very expansive, but we are not able to treat someone and permanently heal them from whatever their problem is, so we want to be able to give them to a doctor and say, here’s what the problem is.  You need to fix them.  When you are stuck in the back of an ambulance and you are on a long transport; I worked for a private ambulance company and we would take people 4 or 5 hours away, mostly those people are stable.  Working in Geauga County and transporting trauma patients or anaphylactic patients for a half hour or 40 minutes those are times where the ambulance can’t go fast enough because when you’re taking care of someone and you are alone, and you are not wanting them to tank, you don’t want to be in the back of the ambulance. You just want them to be okay and you want to get to the hospital where there is a doctor.

Mr. Jerome stated, the bottom line is we are looking to possibly go to 4 full-time and fifth part-time?

Chief Carcioppolo replied, I am looking at that.

Mr. Jerome asked, but even with that, that would not necessarily help the situation?

Chief Carcioppolo replied, no.  We would pretty much be where we are at right now.  When someone is off, we are still at four.  We have never had the ability to drop down a guy.  I don’t know that we ever would be able to.  But just having four full-timers on duty, instead of having a full-time and a part-time combination supplemented with part-time people, we would have a full-time staff that is supplemented and that would make scheduling and keeping bodies in the station a lot easier. So we would still be at 4 most of the time.

Mr. Jerome stated, I think we should still keep definitely looking into that.

Chief Carcioppolo replied, I have been talking with Ron and the Mayor about it.

Mr. Jerome stated, we are definitely at that point.  We may be a small Village but we have thousands of people during the day.  Okay.  It sounds like we have a good dialogue on that.

Mr. Wynne asked, the individual you are talking about just needs transportation to an appointment versus an emergency situation?

Mr. Jerome replied, not necessarily an appointment, but a specific doctor at a specific hospital.

Chairman Marrie asked, for an emergency?

Mr. Jerome replied, yes.  Apparently the doctor said that they did not want them going to UH because they were going to do something wrong.  They needed to come directly to him at the UH hospital as opposed if they went to Ahuja first.  That’s what the doctor’s opinion was.

Chief Edelman stated, that’s between him and Ahuja.

Mr. Wynne asked, does the Community Partnership on Aging offer transportation services?

Ms. Wolgamuth asked, non-emergency ones?

Mr. Wynne replied, yes.

Ms. Wolgamuth replied, probably for seniors, yes.

ANY OTHER MATTERS

Chairman Marrie asked, any other matters?

There were none.

There being no further business, the meeting adjourned at 7:18 p.m.  The next Safety and Service Committee meeting is scheduled for Monday, November 7, 2016 at 7:30 p.m. in the Reserve hall at the Mayfield Village Civic Center.