First responders in quandry at accident

LAFAYETTE-To transport or not to transport? This is the dilemma that confronted the Lafayette Fire Department First Responders one very cold day. The question first arose on a bitterly cold winter day when the emergency response arm of the fire department was faced with whether or not they should bring an accident victim to the hospital. As "first responders," they are supposed to extricate and stabilize the victim, but to wait for EMS personnel or paramedics to come in an ambulance to transport him to the hospital. But as rescue personnel, they are also supposed to save lives. And on this day, the temperature had dropped to one degree, with a wind chill of -22 degrees, and the victim was placed in the emergency vehicle. When paramedics arrived at the scene, it was determined that the individual should not be moved, even to be transferred to another vehicle. As he was already in Lafayette's rescue vehicle, which is outfitted as an ambulance, township first responders transported him to the hospital. The problem is that the New Jersey State First Aid Council does not allow first responder units to perform ambulance services. First responders are just that n the first to respond to an accident. Their job is to extricate victims from vehicles and provide first aid. Ambulances The legal ramification of the vehicle leaving the township became a problem when the department was told that under the guidelines of the New Jersey State First Aid Council, they were not permitted to perform as an ambulance service. This was cited in a memo from VandenHeuvel & Fountain, insurers for the township. Cpt. Rory McGuinness came to the town council's last meeting to report on the situation. He said that the fire department is not a member of the council, it is not restricted by the council's guidelines, and further that volunteer emergency groups are not required to be members. Lt. Ron Decker said, "The council is just an organization that helps with different things." The contentious area is whether two Emergency Medical Technicians must accompany the patient to the hospital. McGuinness said, "We have people of higher training level than that required of a first responder. The title ‘first responder' doesn't reflect our level of training." The emergency response group was implemented as a result of the fire department being called to motor vehicle accidents. The first responders' training is 40 hours and is an advanced basic first aid course. EMTs training is 110 hours of classroom time plus 10 hours at a hospital under the supervision of a medical professional. Paramedics are not volunteers, and their training consists of 1,000 hours of classroom education and an addition 1,000 hours hospital and field work. Lafayette first responders handle 250-290 calls per year, and they are "trying to find a better way to get the people into the hospital. The frustration lies in the fact that we want to get these people to where they need to go," said McGuinness. The vehicle used to transport was donated by a businessman who wishes to remain anonymous that is outfitted with the same equipment as on an ambulance. "Our rescue vehicle has everything that Blue Ridge has," said McGuinness, Blue Ridge being the ambulance company serving Lafayette and five other county municipalities. The dispatch protocol from Newton is that Blue Ridge and Lafayette are called simultaneously. If there is no response, the call is repeated again 3-4 minutes later, and yet a third time. If Blue Ridge is at their building, it takes 14-15 minutes "Last week, we waited 45 minutes to transport a cardiac patient, which is not acceptable," said McGuinness. Fire Captain Joe Farishon, said that there is little a first responder can't do. "We're not willing to let somebody die," he added. Decker said, "We would only transport in dire emergencies." Farishon explained, "The first aid council requires two EMTs in the rig; the state requires one EMT and a driver. Most often the driver is also an EMT, and two can operate a rig. One is working and the other is driving." The average response time for the Lafayette department is 4-6 minutes. "We can have somebody go directly to the scene. We generally have more than one person show up on a call; it's very, very rare to have only one person. We are available 24-7," said McGuinness. Farishon invited the council to "tour the rig" which is set up completely as a rescue vehicle. He said, "It's not just an ambulance; it runs with rescue tools. It is a multi-purpose vehicle." Our concern is patient care," he continued. "What we want is what's best for the residents of Lafayette." The council assured the representatives that there would be further investigation. At that same meeting, the council approved the appointments of two junior firefighters, Mike McGuinness, a sophomore at Pope John High School who will soon be 16, and Daniel Maat, 16, a freshman at High Point. As firefighters in training, they are under the direct supervision of a senior member and assist with the trucks, although they are not permitted to enter a building.