April 26, 2009

Dallesport raises ambulance concerns

By Kathy Gray
of The Chronicle

     DALLESPORT — After two call errors in less than a month resulted in delayed ambulance response times, Dallesport residents filled the community center Thursday to talk about ongoing concerns with Skyline Hospital service.
     “There is a growing concern in our community regarding the availability of ambulance services in Dallesport and Murdock,” said a notice of the meeting that Dallesport volunteer first responders hand-carried to local residents.
     The volunteers also said Skyline had, for some time, not been responsive to requests to meet and resolve issues. Hospital officials argued otherwise, but county emergency commission members backed up the volunteers’ claim.
     About 40 people were on hand for the meeting, which was moderated by Klickitat County Commissioner Dave Sauter. Many of the meeting questions were for Mike Madden, Skyline Hospital’s administrator, and Robert Guinn, the hospital’s ambulance service manager. Also on hand for the talk was Eric Anderson of Klickitat County Sheriff’s office and Bob Palmer of Mid-Columbia Fire & Rescue, which provides mutual aid to the Dallesport area.
     The incidents that prompted the meeting occurred March 25 and April 6. Under Dallesport protocol, when the ambulance — one of only two Skyline operates for its service district — is located west of Lyle, dispatchers are supposed to call Mid-Columbia Fire & Rescue in The Dalles for a mutual aid response. In both cases, the Dallesport ambulance was outside the area, but was called anyway.
     In the March 25 case of a man without a pulse, a dispatch tape indicated a delay of almost six minutes before the Dallesport ambulance instructed dispatch to call for mutual aid.
     “It was eight minutes before Mid-Columbia was en route, and another seven minutes before they got over here,” said Dallesport Fire Chief Rhet Howard after the meeting, while reviewing the dispatch tape.
     Dallesport first responders were on scene within six minutes, but did not bring their engine, with its vital emergency response equipment. They had expected the Dallesport ambulance to be on scene ahead of them.
     “Normally, we don’t roll a $200,000 piece of equipment if we know the ambulance is going to beat us there,” Howard said during the meeting.
     Had they immediately known mutual aid had been called, they would have brought the engine and its equipment, instead of responding directly to the scene.
     The elderly man died, but it is unknown whether a quicker response might have changed the outcome, noted Cindy Roden, another Dallesport emergency responder.
A similar scenario occurred during the April 5 rock-climbing fall at Horsethief Lake.      Dallesport’s ambulance was west of Lyle, but was called anyway, resulting again in a delay of service.
     Initial complaints from Dallesport residents at the meeting were that the Dallesport ambulance is out of the area too often. Madden responded, explaining that the ambulance is one of only two for the hospital’s entire service area. The other is based in White Salmon.
     Skyline based an ambulance in Dallesport after the community voted to support an emergency services levy in 2001, and contributed $31,000 to build a garage for the ambulance on volunteer fire department land.
     When the White Salmon-based ambulance is out on a call, either within the district or on a transfer, or is out of service, the Dallesport ambulance moves to either Lyle or White Salmon to provide more central response to the entire district.
     While some audience members thought Skyline had two full-time crews to service Dallesport, Madden explained otherwise: “We have two full-time crews, 24-7 to service the whole hospital district.”
Funding is not adequate for additional coverage, Madden said, adding that the hospital subsidizes the ambulance program above and beyond the funding provided by the levy.
Out-of-district transfers were another source of concern, particularly those to Portland. Several audience members felt they detracted from service within the district.
Madden argued that some medical services can’t be provided in the gorge, so the ambulance provides transfer service. The ambulance also provides transfers when those based in The Dalles, Hood River, Goldendale or Skamania County may not be able to. In return, other agencies provide similar aid when Skyline can’t.
Eventually, meeting focus settled on the two recent response errors. Dallesport first responders suggested that some kind of notice to them when the ambulance is west of Lyle would help volunteers respond appropriately, depending upon whether the Dallesport or The Dalles ambulance is responding. They asked for some kind of signal on the ambulance garage, but Guinn was concerned about security issues.
Eventually, the group settled on having dispatch centers in Goldendale and The Dalles both notified when the ambulance is out of the area. Goldendale dispatches the ambulance itself, and The Dalles dispatches Dallesport first responders due to radio coverage issues.
     Anderson, of Klickitat County, also agreed that the county would organize a meeting between dispatch, Skyline and Dallesport Volunteer Fire Department to discuss developing appropriate protocols for emergency calls involving the three organizations.