HomeMy WebLinkAboutItem 4.1 Paramedic Advisory Ballot (2) AGENDA STATEMENT
s of DUB.C.1:AP
Meeting Date: October 25, 1982
SUBJECT : Paramedic Advisory Ballot - Presentation by Chris West
EXHIBITS ATTACHED : Measure "C" Synopsis
RECOMMENDATION .• Receive Presentation
FINANCIAL STATEMENT: None
DESCRIPTION : Chris West, Eden Hospital has requested an opportunity to
address the City regarding Measure "C", the paramedic
service advisory measure.
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COPIES TO: Chris West
ITEM NO. "Y '
ADVANCED LIFE SUPPORT TALK OUTLINE
I. History of ALS
II. ALS vs. BLS
A. Training/Education
B. Field Scope of Practice
III. Response System of AIS
IV. Citizen CPR
V. Questions and Answers
Speaker: Chris West, RN", MICN (Mobile Intensive Care Nurse)
Nursing Co-ordinator Emergency Room/Surgery Evening Shift:
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MEASURE C: PARAMEDIC SERVICE IN ALAMEDA COUNTY
PURPOSE:
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This is an advisory vote to assess the willingness
}_ • of the voters to support .a maximum $10 annual fee
per residence to create a paramedic service in
Alameda County. Support for the measure must result
in adoption of tax assessment by County Board of
Supervisors and approval of cities to participate
4 in program before it would take effect. Total
annual cost of program expected to be $3. 1 million,
broken down as follows :
Indigent and Dry Run Costs $1 ,500 ,000
__ . Base Hospitals (5) 125 ,000
Training, Equipment , Amortization ' 223 , 000
Central Dispatch 510 , 000
Central Administration: Medical Control 335 , 000
Five Service Personnel .
Communication Equipment epreciation 285 ,000
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BACKGROUND:
• A federally subsidized 18 month pilot •project was
implemented in late August , 1982 . Eden is one of
three hospitals in the county voluntarily participating
in pilot program. Internally budgeted costs .to Eden
have been $29 , 000 for FY 1982 and $51 ,274 for FY 1983.
Two-thirds or more of costs are personnel , i. e. , liaison
nurse and physician consultant time. No revenue was
projected for either year. In practice , program may
generate more admissions to Eden Hospital than would •
otherwise occur. Such revenue is , however , difficult
to track. Eden' s involvement in pilot program does
generate some community-public relations benefits ; again
the value defies an easy monetary relationship.
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Under the pilot program, most costs of training, equipment ,
and implementation have been borne by ambulance companies ,
the paramedic trainees and the hospitals . Measure C
would allow some subsidy/compensation to ambulance companies
and hospitals . For Eden, it would' be at least $25 , 000
per year.
IF MEASURE C FAILS :
Pilot program will continue through December , 1983
roughly. Afterwards , Paramedics could still be in place
with ambulance companies allowed to charge their costs
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Current pre-hospital care in Alameda County, which includes
ambulance and some fire department personnel, is provided by
Emergency Medical Technicians . These Emergency Medical Tech-
nicians (EMT' s) are trained in the basic life support skills of
patient assessment , oxygen therapy, taking vital signs (pulse,
respirations , blood pressure and level of consciousness) .
Alameda County is the last major county in California and
the only Bay Area County that does not have Paramedics/Advanced
Life Support .
' Alameda County Paramedics will be fully trained and well
equipped to handle a wide scope of life threatening emergencies
ranging from chest pain-heart attack, shortness of breath, allergic
reactions and poisonings , asthma attacks., diabetic emergencies ,
seizures , emergency childbirth, shock, and major trauma caused by
auto accidents or violent crimes , such as stabbings or gunshot
wounds ._
CAN YOU SEE A DIFFERENCE . . .
Your friend/relative is watching TV and suddenly becomes
short of breath complaining of a crushing chest pain radiating
to the left arm and jaw, and perspiring heavily . You dial 911
and the emergency medical response plan is activated. The Fire
Department and an Ambulance are enroute to your home .
When the Basic Life Support (BLS) unit arrives the patient
will receive immediate limited care . The rescue personnel will
obtain a brief history of the patient and take his blood pressure ,
pulse, respirations , and the patient will be given supplementary
oxygen and transported to the nearest basic emergency hospital.
Comparatively, when the Advanced Life. Support (ALS) unit ar-
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rives the patient will be completely evaluated in addition to the
BLS evaluation. Advanced care will be initiated: the patient will
be connected to a cardiac monitor, intravenous lines established,
essential medications administered, airway management enhanced,
and specialized equipment utilized as needed before transport. At
all times the Paramedics will be in direct contact with the Nurse
and Physician at the designated basic emergency hospital via
specialized radio and telemetry equipment . The Paramedics are the
eyes , ears , and hands of the Physician, and receive their orders
directly from him.
Now that you realize the difference , please help us help the
Board of Supervisors promote the Paramedic program through a
benefit assessment.
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if some hospital (s ) willing to absorb costs
to act as central control , (probably unlikely) .
Or situation could revert to pre-pilot phase of no
paramedic availability and only EMT-I riding in
ambulance.
IF MEASURE C PASSES :
County has to implement program which will take at least
.18 months December , 1983) , Costs to users would
be reduced and subsidy to hospitals would occur although
• subsidy would not match costs .
ISSUES:
• eIs paramedic availability better than EMT-I? Yes .
Even in urban areas with an abundance of accessible
hospitals , skilled field personnel are instrumental
in determining positive outcomes . Without Measure C ,
widespread availability of paramedics is dim:
•Will Measure C Paramedic Program assist Eden Hospital
. financially? Only to a degree. Costs will always
exceed measurable revenues . Tax based income will
offset some costs , but not all. Real issue is whether
Eden considers involvement a positive community service
and important to its ' role in South County.
Is Measure C politically desirable? On medical grounds ,
yes . In terms of relations with local political groups ,
i. e. , firemen, chambers of commerce , taxpayer :associations ,
etc. , the situation is iffy. Measure C is 'a property
based tax with a lot of apparent overhead; local support
for issue is problematic. Less costly alternative may
be available , but are unknown. •
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