Amagansett Fire Department Ambulance anticipates having to rely on mutual aid for its more serious calls as of this Sunday, December 1, when it is set to switch from an Advanced Life Support, or ALS, agency to a Basic Life Support, or BLS, agency. But it views the change as an interim phase until a planned paid paramedic program gets off the ground, possibly as early as January.
The ambulance company is losing its ALS certification from the State Department of Health, a certification it has held for many years. Its sole ALS volunteer, Tom Field, citing fatigue and lack of continued interest with the demanding role, has opted not to renew his more advanced credentials and, instead, will continue his volunteerism as a basic emergency medical technician.
Without an ALS volunteer on the corps, Amagansett must also remove from its fleet certain equipment and medications that only advanced EMTs are certified to use. Those items, which are owned by the Amagansett Fire District, are to be placed into storage, officials said.
In the meantime, the district’s board of fire commissioners, the elected body that holds the purse strings for the ambulance company and fire department, aims to get a paid paramedic on board as soon as possible in the new year. When this happens, it also expects to return the advanced equipment to the ambulances.
Advanced EMTs undergo more training than basic EMTs and can do more skilled procedures, such as IV therapy, injections and advanced airway techniques, which basic EMTs do not do. Paramedics perform mostly the same procedures as advanced EMTs but receive even more training and technical knowledge and can specialize, working as a flight medic on a helicopter, for example.
Following a paid-paramedic model piloted by Montauk this past summer, the board has budgeted approximately $105,000 to 110,000 for one paid paramedic to be on duty at a time during 2014, according to Daniel Shields, II, the board’s chairman. The paramedic would respond to advanced calls, such as those for heart attacks and more life-threatening situations. The post would be full time in the summer and part time in the off season.
“Ideally, I’d like to get this started in January or February, but it will take a while to get our ducks in a row. It’s a lot of paperwork. I would just love to get this done sooner rather than later,” he said. “We want to do the best service we can provide for the taxpayers of Amagansett. We don’t want to go backward.”
Meanwhile, Sunday starts a new dawn for the company, when Mr. Field slips back into the ranks of the basic EMT. It is also the day by which all ALS workers must be certified with a new exam under new Suffolk County protocol. Mr. Field, despite saying he was not into it anymore and is “pretty worn out and tired,” called the protocols “absolutely awesome and phenomenal” and ultimately better for patients. They now allow advanced EMTs to go further with cardiac calls, for example.
“If you don’t have your head screwed on straight, if you’re not up to snuff, it could be dangerous,” he added.
Amagansett used to have a greater number of advanced EMTs over the years, sometimes having three at a time, but their numbers dwindled, in part as residents find less time to volunteer, officials said. “He’s the one and only guy,” Mr. Shields said of Mr. Field. “I think it’s just a little overwhelming at this point, for one man to do it all.”
Practically every spare minute not taken up by work or teaching a class, Mr. Field would spend doing paperwork for a controlled substance program, Mr. Shields said.
“When people don’t have enough time to hire per-diem paramedics,” Mr. Field said. “The whole idea is we can’t get anyone to spend the enormous amount of time to get training. It’s a tremendous amount of time and effort.”
The training and paperwork are on top of the time required to break away from jobs to respond to calls, which could take up to as many as five or six hours for the most severe ones. “Fewer and fewer people can do that and work multiple jobs and still survive in this economy,” he said.
As of Sunday, Amagansett will rely on mutual aid with neighboring agencies as it did prior to having any ALS volunteers, Mr. Field explained. “This, theoretically, is for a very short term,” he stressed, referencing the impending start of the paid paramedic program.
If the company receives an ALS call during this period, residents should not expect a dip in service, officials said. “If you live in Amagansett and need advanced life support, your care is not going to be compromised, because dispatch already knows,” said East Hampton Village Ambulance Association Chief Mary Ellen McGuire. “They’ve already got East Hampton toned out for ALS. It will happen simultaneously.”
She continued, “Amagansett not having it just means our folks are going to work harder,” she said, “which is fine, because for so many years Amagansett has helped us.”
If Amagansett does need an ALS call, she said, East Hampton or even Springs or Sag Harbor, which also have ALS volunteers, could just transfer the patients to their ALS-equipped ambulances. “We do that a lot anyway, depending on what’s going on. We do a tremendous amount of mutual aid. It’s just that we’re going to be down one more ALS provider, which is sad.”
Ambulance companies, she observed, are not stagnant organizations. They are constantly moving and evolving, meaning that if one company is missing something one day, another can provide it and vice versa.
Kent Howie, one of the Amagansett commissioners, noted that until a paid paramedic comes on board, Amagansett will depend heavily on its neighbors.
“We’re trying to do everything we can to maintain or better the performance we provide for the community,” he said. “We’re working diligently.