Gilroy
– Two years after the first paramedics rolled out of Las Animas
Station, members of the Gilroy Fire Department still remember the
first life that paramedics saved.
An 80-year-old woman suffered a major heart attack in her home
in May 2003, five months after paramedics were stationed at Las
Animas and two months after they joined Chestnut Station.
By Lori Stuenkel
Gilroy – Two years after the first paramedics rolled out of Las Animas Station, members of the Gilroy Fire Department still remember the first life that paramedics saved.
An 80-year-old woman suffered a major heart attack in her home in May 2003, five months after paramedics were stationed at Las Animas and two months after they joined Chestnut Station. A team of firefighter/paramedics arrived and revived the woman, saving her life and preventing major brain and heart damage.
“She walked out of the hospital a week later,” said Phil King, Emergency Medical Services division chief for GFD.
Because the paramedic program has saved lives, there’s no question whether it has been worth the effort, cost and a nearly four-year phase-in, King said.
“I think there’s a lot of examples of people that would not have been here today, … as well as other people just getting more immediate and better care,” said Jeff Clet, chief of the San Jose Fire Department, who was GFD chief when the paramedic program was launched. “I think people are seeing a benefit every day.”
Gilroy was the last department in the county to implement a paramedic program and in early 2000, was failing to meet its goal of a 5-minute response time for 95 percent of calls. Now, the GFD and its 12 firefighters are on par with other departments in the county on medical aid calls – an estimated 75 to 80 percent of all calls for service – with one paramedic responding to each call as part of the four-person engine crews from Las Animas and Chestnut, or the two-person crew from Sunrise Station.
One service GFD paramedics have been providing less often than anticipated is transport to the hospital in the STAR car. The $268,000-vehicle stationed at Sunrise a year ago is a specially designed heavy-duty rescue ambulance that also carries an assortment of fire-fighting tools and rescue equipment.
The only time the vehicle transported a patient was last October, following an accident on Hwy. 152 east of Gilroy that involved multiple casualties. The department had anticipated revenue of $9,000 per year from transporting between one and two patients each month.
“From our standpoint, transportation is only one part of its use,” King said. “It is a really good thing to have because it’s just that … support to the system. It’s primary use is to be a first-response unit out of Sunrise.”
It can get paramedics to patients who otherwise might wait minutes longer, he said. A fire engine cannot currently be housed at Sunrise because the city does not have the funding for a full four-person staff.
Meanwhile, the paramedic program keeps evolving: Just before the start of the year, electrocardiographs that produce higher quality images were added to each GFD engine and the Supplemental Transport Ambulance Resource (STAR) vehicle used by paramedics.
The new EKG uses four times more electrodes to read the heart from nearly every perspective, where the machines used previously could only show a small percentage. GFD paramedics will operate the machines, which until recent years were only available in emergency rooms.
“By giving you that 360-degree view of the heart, it allows us the ability to see some of the things that we were missing before, and to be able to get a better idea of what’s going on,” King said. “You can recognize impending heart attacks, see past heart attacks. We can be more aggressive with our treatment.”
Gilroy was one of the last fire departments in the county to acquire the machines, partly because its paramedics program is the youngest, King said.
In the next couple of months, a machine that can keep a damaged heart pumping, called a “pacer,” will also be added. Pacers are used on patients whose hearts are pumping so slowly, their blood pressure is too weak to push blood to the brain and other organs. Where defibrillators use large amounts of electricity to shock a heart back into rhythm, pacers start at zero.
“We can give them just a little bit of electricity so the heart will pump,” King said. “We start at zero and work it up in increments to where it gives just enough electricity to contract the heart and make it beat – so we do that 60 times a second.”
American Medical Response (AMR) provides ambulance services for the county, and Gilroy firefighters can only transport patients in the STAR car when an ambulance cannot arrive on scene, or is more than 18 minutes away. In that case, one ambulance each from Gilroy, San Martin, and Morgan Hill would likely be occupied by calls or in the northern part of the county, King said.
GFD’s 12 paramedics mean each of the three stations will always have one on duty. The paramedic or Advanced Life Support (ALS) certifications allow them to provide advanced cardiac care, advanced pediatric care, administer intravenous fluids and advanced drugs at a trauma scene.
The transition to staffing engines with one firefighter/paramedic trained in ALS from an all-Emergency Medical Technician (EMT), or basic-level life support, can be challenging, King said.
“For one, you have people that are coming in who are very young, or new to the department, and they are somewhat in charge on some calls,” he said. “You have a paramedic who now is the person responsible for the medical part of the call, and so there’s supervisory sharing between the paramedic and the captain, and generally, it’s a very difficult transition to make. But in this department, they were ready to go.”
Part of the reason was Gilroy firefighter/EMTs already saw that, on some calls, a paramedic’s skills were needed. Even before the paramedic phase-in, GFD began training firefighters to be enhanced EMTs because they were “on board,” King said.
Clet, who is now San Jose’s fire chief and was Gilroy’s chief from 2003-04, called Gilroy’s a “model program.”
The city needed to hire some seven firefighters to staff Sunrise, which opened in August 2003. The new hires were already paramedics, Clet said, so hiring was completed well in advance to release other GFD firefighters for certification before the program was launched.
The program does come at a cost: Paramedics earn 11 percent more than EMT firefighters and with 60 hours of college credits, their base pay jumps from $65,735 to $72,9667. The increase in the department’s overtime pay is roughly $100,000 – from about $297,000 to $397,000, according to figures from the city.
Continuing education – 48 hours per paramedic, every two years – is also an added cost, and the city in November completed a $105,000 purchase of additional paramedic equipment for all back-up engines.
The GFD is already looking to lower the cost and time for re-certifications by providing them in-house.
“It keeps (paramedics) from having to go on their days off, it keeps us from having to pay overtime, and it can be done on-duty,” King said. “It makes it a lot easier to coordinate.”
Paramedic program
Timeline of the Gilroy Fire Department paramedic program
– March ’00 – Measure M, meant to fund staffing and a paramedic program, fails to get two-thirds voter approval
– May ’00 – City Council looks at sites in northwest Gilroy for a third fire station
– June ’01 – Council approves a paramedic squad and nine new firefighting positions
– Feb. ’02 – City buys Sunrise station site; GFD paramedic program plan formalized
– Jan. ’03 – Las Animas fire station staffed with paramedics
– Feb. ’03 – Phil King hired as division chief of Emergency Medical Services
– March ’03 – Chestnut fire station staffed with paramedics
– July ’03 – Sunrise fire station opens with two-person staff
– Feb. ’04 – Supplemental Transport Ambulance Resource (STAR) vehicle added to Sunrise station
– Nov. ’04 – All GFD engines and STAR vehicle equipped with paramedic equipment
Sources: Gilroy Fire Department, Division Chief Phil King
