LR greenlights change for MEMS

Little Rock’s emergency services on Tuesday became the first in the state fully authorized to dispatch less-equipped ambulances for less-severe 911 calls after Little Rock’s Board of Directors made a pilot program permanent.

City directors without discussion unanimously approved the change for Metropolitan Emergency Medical Services. The shift comes as the state Health Department develops a rule that would allow the practice statewide.

The two-tiered response to 911 calls allows dispatchers to send basic life support, rather than advanced life support, to emergencies that do not require high-level treatment such as the administration of pain medication or a breathing tube. Advocates said it allows agencies to use resources more efficiently and that the Little Rock change will result in more ambulances on the street.

MEMS, a nonprofit agency, serves more than a half-million residents in Pulaski, Faulkner, Grant and Lonoke counties, though the change for now is exclusive to the capital city.

Ambulances providing advanced life support must have at least one paramedic, who is licensed to do more for patients than the emergency medical technicians who can provide the alternative, basic life support.

City directors last June authorized MEMS to test the method, the first time in the agency’s 35-year history that it was allowed to send basic support to lower-priority calls. The agency has since dispatched basic life support to 2,553 calls. In those cases, advanced life support was subsequently called to the scene 14 times, said Jon Swanson, the agency’s executive director.

One of those 14 so-called intercepts was because a patient had low blood pressure, one was because the patient started having a seizure after the medics’ arrival and one was because a patient reported chest pain after the medics arrived, Swanson said. The other 11 cases were related to the patients’ need for medication, he said.

Previously, basic support could be sent only after all advance support ambulances were occupied. Rather than reducing the number of units with paramedics, the agency will increase the number of basic-support units it has active on any given day, from six to 10, he said. Before the pilot program, basic units were used solely for transport purposes, not for responding to 911 calls.

When 911 call comes in, a dispatcher asks several questions to determine the nature and severity of the emergency. All calls begin with the assumption that advanced support is needed, and basic support is only dispatched if the facts of the call show it is warranted, Swanson said.

During the trial period, lower-level ambulances were most commonly dispatched to reports of general sickness, he said.

The Arkansas Health Department, which licenses ambulance services, signed off on the change and expects to finalize a new rule by early fall that would allow the rest of Arkansas to follow suit, said Greg Brown, the department’s branch chief over trauma, preparedness and emergency medical services.

The statewide rule — which has not drawn opposition at public hearings — would require participating emergency-management services agencies to provide additional training to dispatchers and to meet other standards, Brown said. More heavily populated areas, like Northwest Arkansas, likely would adopt the tiered approach before smaller, rural areas do, Brown said.