Ru­ral EMS at Risk

Catron Courier - - News -

This ar­ti­cle is brought to you by your lo­cal am­bu­lance ser­vice. It is one of a se­ries of ar­ti­cles that will dis­cuss the chal­lenges ru­ral EMS ser­vices face in the com­ing years.

Ru­ral EMS is chang­ing and the chal­lenges it faces ahead threaten the abil­ity of ru­ral EMS ser­vices to sur­vive.

It’s hap­pen­ing in towns across the coun­try and whether or not you are aware; it’s most likely oc­cur­ring in your town too. Many ru­ral am­bu­lance ser­vices are shut­ting down or con­sol­i­dat­ing with neigh­bor­ing towns. Na­tion­wide, it is es­ti­mated that up to three ru­ral agen­cies are clos­ing each month.

What’s go­ing on? It’s been called the “per­fect storm.” For years, ru­ral towns have de­pended on lo­cal com­mu­nity vol­un­teers to staff their am­bu­lance and firstre­spon­der ser­vices. But that has be­gun to change.

Chang­ing so­cioe­co­nomic con­di­tions are plac­ing more de­mands on peo­ple’s time and an ag­ing vol­un­teer base is re­sult­ing in a shrink­ing vol­un­teer pool.

Lack of fund­ing is also a ma­jor prob­lem. Con­trary to pop­u­lar be­lief, most am­bu­lance ser­vices re­ceive no fund­ing from fed­eral, state or lo­cal gov­ern­ments. Many ser­vices rely al­most en­tirely on pri­vate do­na­tions and lo­cal fundrais­ers.

But those dol­lars are no longer enough to pay for the in­creas­ing costs as­so­ci­ated with run­ning an am­bu­lance ser­vice. Just as medicine as be­come more ad­vanced, so too have the ex­pec­ta­tions placed on EMS ser­vices. Ev­ery town wants an am­bu­lance equipped with the lat­est lifesaving med­i­cal tech­nol­ogy in ad­di­tion to well-trained EMTs. Vol­un­teers of­ten don’t have the time or the money to in­vest in that type of ed­u­ca­tion and on-go­ing train­ing. Keep­ing up with the lat­est med­i­cal tech­nol­ogy is of­ten pro­hib­i­tive to ru­ral EMS ser­vices and the cost of op­er­at­ing an am­bu­lance ser­vice of­ten out­paces the money they bring in.

So why can’t the fed­eral or state govern­ment step in and fix the sit­u­a­tion? EMS ser­vices are not fed­er­ally man­dated nor is there long-term fed­eral fund­ing. The same is true for most states.

How crit­i­cal is the sit­u­a­tion? How badly would ru­ral towns suf­fer with­out re­li­able

emer­gency ser­vices? In many cases, it could mean the dif­fer­ence be­tween life and death, ac­cord­ing to a re­port en­ti­tled “Emer­gency Med­i­cal Ser­vices in Ru­ral Amer­ica” pro­duced by the Na­tional Con­fer­ence of State Leg­is­la­tures in April 2007. The con­fer­ence brought to­gether ex­perts from around the coun­try to in­form pol­i­cy­mak­ers about the chal­lenges fac­ing emer­gency med­i­cal ser­vice providers in ru­ral Amer­ica and re­ported these sta­tis­tics: • The rel­a­tive risk of a ru­ral vic­tim dy­ing in a mo­tor ve­hi­cle crash is 15 times higher than in ur­ban ar­eas, af­ter ad­just­ing for crash char­ac­ter­is­tics, age and gen­der. • In­jury-re­lated deaths are 40% higher in ru­ral com­mu­ni­ties than in ur­ban ar­eas. • 87% per­cent of ru­ral pe­di­atric trauma deaths did not sur­vive to reach the hos­pi­tal.

Ru­ral am­bu­lances in ru­ral Amer­ica are dis­band­ing na­tion­wide due to a lack of fund­ing and vol­un­teerism. This is cre­at­ing ma­jor is­sues con­cern­ing the abil­ity to pro­vide timely emer­gency care. The first hour is cru­cial. Trauma pa­tients who can be trans­ported to a trauma cen­ter quickly have fewer com­pli­ca­tions and are more likely to sur­vive. Nearly 85% of US res­i­dents can reach a level one or level two trauma cen­ter within an hour, but only 24% of res­i­dents in ru­ral ar­eas have ac­cess within that time frame. Timely emer­gency care will only get worse with the grad­ual dis­man­tling of ru­ral emer­gency care. Wait times will be longer if towns have to de­pend on ser­vice from neigh­bor­ing towns.

Noted one ex­pert in the re­port, “Like good wa­ter and great schools and healthy en­vi­ron­ments, emer­gency med­i­cal ser­vices and trauma sys­tems are a qual­ity of life is­sue.”

Please get to know more about your lo­cal am­bu­lance ser­vice and the chal­lenges it is fac­ing to­day. Watch for an up­com­ing ar­ti­cle about prob­lems ru­ral towns face con­cern­ing emer­gency ser­vices and vol­un­teerism.

(Ed. While Ca­tron County EMS re­ceives state fund­ing, like other ru­ral ser­vices EMS in our county faces fund­ing and vol­un­teer is­sues. A First Re­spon­der course is be­ing taught this June & July—see Events on Page 2 for more in­for­ma­tion—and Ca­tron County EMS main­tains some of the best train­ing avail­able. Do ask what you can do to help your lo­cal EMS— vol­un­teers are al­ways needed and it in­deed a case of many hands mak­ing the work much lighter. Check with your lo­cal EMS to ask how you can help. This in­cludes Re­serve, Glen­wood, Luna, Que­mado, Datil, Pie Town, Apache Creek Res­cue, and Horse Moun­tain Res­cue.)

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