Vancouver fire department takes the heat
City weighs own ambulance contract
The call came in as an unconscious 42-year-old male, and the person who called 911 didn’t offer emergency responders much help figuring out what might have happened.
Vancouver firefighter-paramedic Mark Bennett, Capt. Gregg Roberts and recruit Anthony Slagle arrived at the residence slightly ahead of a two-person crew from American Medical Response, a private ambulance company.
The patient was on a bed in a darkened room. Bennett checked his pupils, which were pinpoint — a sign of opiate overdose. Bennett lifted up the sleeves on the patient’s shirt and saw needle tracks. He pricked one of the patient’s fingers to test for blood sugar, which was normal. The patient’s breathing rate had slowed.
Roberts, clipboard in hand, documented what Bennett was doing while an AMR employee asked the person who called 911 for clues. The man, who said he was a neighbor who had come over to watch a movie, didn’t know the patient’s last name. Roberts asked if there was any mail, or something else that would have the patient’s name on it. He found the name on prescription pill bottles.
The man volunteered that he knew the patient had been on some “heavy painkillers” and recently drank a few beers.
“I can smell the beer,” responded Bennett, leaning over the patient.
One pill bottle was labeled oxycodone, a powerful painkiller. It had been prescribed two days earlier, for 40 pills. The bottle was empty.
Bennett injected the patient with one dose of naloxone, which blocks opiates from working and can send a person into acute narcotic withdrawal. The patient came to, said a few words and blacked out again. Bennett gave him a second dose, which did the trick.
Bennett, Slagle and the AMR employees lifted the patient onto a stretcher. He began vomiting as he was wheeled out to the ambulance.
Bennett later explained he didn’t think the man had taken all 40 oxycodone pills in two days.
“He could have got a prescription and then sold the oxy for heroin, which would give him a better high,” Bennett said.
The Feb. 26 incident had been the third back-to-back call for Bennett, Roberts and Slagle.
Other calls that shift included a dryer fire, an elderly woman who hadn’t been able to eat in three days, an elderly man with chest pains, a younger man with chest pains, a man attempting to illegally burn garbage in his backyard and an intoxicated man a driver saw tumble down a hill along state Highway 500 (he was face-down when firefighters arrived). They also responded to a single-car accident in which a man sustained minor injuries.
Bennett and Roberts are assigned at Station 2 in west Vancouver, the city’s second-busiest station that averages 12 calls a shift. Station 3, in the Heights, ranks as the busiest, while Station 7, in Glenwood, ranks the slowest.
The department responds to approximately 23,000 calls a year.
Slagle, as a recruit in his probation year, can be assigned to any of the city’s 10 stations as needed. Firefighters work 24 hours on, 48 hours off, and Station 2 has only an engine, so it’s staffed by three people. Each station has at least an engine; two stations also have a ladder truck staffed by four people. The next shift Bennett and Roberts work, they are joined by first-year firefighter Isaac Eldred, who, like Slagle, doesn’t have an assigned station.
At any given time, a total of 38 firefighters, firefighter-paramedics and captains in addition to two battalion chiefs are on duty.
Starting April 1, two teams of two (a firefighter and a firefighter-paramedic) will work 10-hour shifts in an SUV to respond to lower-level medical calls during peak hours to keep engines reserved for higher-priority calls. Calls are ranked priority 1 (the most serious) to 6; the Vancouver Fire Department already lets AMR handle most 5 and all 6 calls alone.
One of the calls Bennett, Roberts and Slagle responded to on Feb. 26 illustrated that determining call levels isn’t a perfect science. A priority 2 call came in about a diabetic, but when the Engine 2 arrived the diabetic told firefighters he just wanted an ambulance. Bennett offered to test his blood-sugar level while they waited, but the man declined and walked over to the ambulance when it pulled up seconds later.
That really should have been a priority 4 call, Bennett said later.
In 90 percent of high-priority calls, the department’s response time is 7 minutes, 51 seconds or better, Fire Chief Joe Molina told the Vancouver City Council in January.
By using SUVs to respond to lower-priority calls, the department hopes to decrease response times, Molina said.
Doug Smith-Lee, EMS manager for Clark Regional Emergency Services Agency, said 911 dispatchers ask a series of questions to try to best gauge the priority of a call, and when in doubt they’ll rate the call a higher priority.
On average, during a 24-hour shift firefighters are either on calls or writing reports a total of eight hours, said firefighter Mark Johnston, president of the IAFF Local 452. Two hours are for meals. For dinners, firefighters usually cook a group meal; they always buy groceries with their own money. At Station 2, firefighters can walk across a parking lot to a Safeway. Shifts run from 7 a.m. to 7 a.m., and crews start with two hours of maintenance, including washing rigs and checking equipment. Another four hours are reserved for training and projects, such as updating binders that show blueprints of buildings in their coverage area that have sprinkler connections, electrical panels and access points marked. Six hours of sleep is a luxury, Roberts said, and firefighters are expected to exercise for an hour as all stations have equipment.
After they’ve finished their chores and exercise, and it’s not time to sleep, they wait to hear the station alarm.
Stephanie Rice: 360-735-4508 or stephanie.rice@columbian.com.
