EMS base discussion

PROPOSED WILKES EMS BASE sites are explained Tuesday night by Wilkes EMS Operations Officer Bryant Reid, at left, and Wilkes EMS Director Tim Pennington, at right, at table in front of the Wilkes County commissioners. Commissioners visible are, left to right, David Gambill, Gary Blevins and Brian Minton. County Manager John Yates and Clerk Sarah Call are at the other table.

A case was made for establishing more Wilkes Emergency Medical Services bases to achieve a goal of responding to at least 90 percent of emergency calls in 10 minutes or less during the Wilkes County commissioners meeting Tuesday night.

Responding in 10 minutes or less “is pretty much an EMS standard across the board throughout the nation. It’s what we strive for,” said Tim Pennington, a veteran Wilkes EMS technician/paramedic named director a year ago.

Wilkes EMS now achieves the 10 minutes or less goal on about 70 percent of its calls, said Pennington, responding when Keith Elmore, chairman of the commissioners, requested this information.

Bryant Reid, Wilkes EMS operations officer, said reaching cardiac arrest patients in Wilkes in no more than 10 minutes meant a 30-32 percent chance of restoring a heartbeat in 2018. “What was drastic was that once it was over 10 minutes, the chance of getting a heartbeat back went down 63.3 percent.”

Reid added, “There are other time-sensitive events, such as strokes, anaphylactic reactions, breathing problems etc., but cardiac arrest is a big one.”

Pennington proposed establishing three new EMS bases staffed 24/7 to help reach the 90 percent goal—one in the Mountain View community, another on East Wilkes Middle School property in the Ronda area and a third on Call Street near the Wilkes County Courthouse in Wilkesboro.

He also proposed making the current daytime-only EMS base in the Millers Creek Fire Station a 24-hour base and added that the Millers Creek Fire Department supports this.

Pennington said the plans call for buying, retrofitting and occupying an existing building on Rock Creek Road in Mountain View in the current fiscal year, constructing an EMS base on the northern end of the 55-acre East Wilkes Middle property in fiscal 2019-20 and establishing a new main Wilkes EMS base as part of an emergency services facility built on county-owned property near the courthouse in fiscal 2020-21.

He said the school property is available at no cost for a base and would be reached from Little Elkin Church Road so it shouldn’t impede school traffic on Macedonia Church Road on the south end of the property.

Pennington said space would no longer be leased for a base in the Shepherds Crossroads Fire Station. He noted that some fire departments, including Mountain View and Ronda, don’t have enough space in their fire stations to house an EMS ambulance and crew.

He noted that all of the proposed EMS base locations have the advantage of being closer to schools.

The plans also call for adding four new EMS employees to staff one more ambulance at night, but no additional ambulances. Wilkes EMS now typically has six to seven ambulances on duty in the daytime and four to five at night.

Last year, the county commissioners discussed but didn’t include funding in the fiscal 2018-19 budget for an EMS base in Mountain View and the emergency services facility on Call Street.

Reid and Riley Mort, analytics specialist and part-time emergency medicine technician, gave a PowerPoint presentation with data to make a case for the additional 24-hour Wilkes EMS bases and their proposed locations.

Reid said that with the current two fulltime (24-hour) bases, Wilkes EMS now has one 24-hour base for every 379 square miles in the 757-square-mile county. One is the main base near Wilkes Medical Center and the other the Shepherds Crossroads base in the Roaring River area.

Reid said the eight counties adjoining Wilkes combined average 158 square miles per 24-hour base. These are Iredell with eight, Caldwell and Yadkin with five apiece, Surry with four, Watauga with three, Alexander with two and Alleghany and Ashe with one 24-hour base apiece.

He said the plan for having four 24-hour bases would leave Wilkes with 189 square miles per base.

Reid said the steady increase in Wilkes EMS emergency response trips from about 7,000 in 2000 to 12,789 in 2018 also adversely impacted response times.

He said this is especially true in eastern Wilkes, since an ambulance at the main base in North Wilkesboro or from some other significant distance must respond to calls in that end of the county if the one ambulance stationed at Shepherds Crossroads is tied up. A PowerPoint map of Wilkes depicting a concentration of Wilkes EMS emergency trips at least 16 miles long to northeastern Wilkes represented when this has occurred.

Reid shared another map showing that although the Wilkes EMS base at Shepherds Crossroads is centrally located for eastern Wilkes, it isn’t centrally located based on call volume in that area due to where people live.

He said moving the main base from the facility leased from Wake Forest Baptist Medical Center to the proposed emergency services facility in Wilkesboro will allow for a more unified command and response to large scale events, improve communications between agencies and position Wilkes EMS for faster response to a large area of the county due to its proximity to U.S. 421.

Making the base in Millers Creek a 24-hour facility will improve coverage in western Wilkes, he said.

Mort said the plan proposed Tuesday night would leave 93 percent of Wilkes residents living less than eight miles from a base instead of the current 83 percent.

She said data shows that the two 24-hour base locations proposed for eastern Wilkes would reduce Wilkes EMS response time by an average of six to seven minutes per trip.

Responding to the Wilkes EMS presentation, Commissioner Eddie Settle said he has been publicly voicing concern about long response times of county emergency services in eastern Wilkes since 2013.

Settle lives in the Pleasant Hill community and said his neighbors can also testify about the long response times.

He added that in addition to the five EMS bases already in Caldwell, that county plans to build two more this year. “Wilkes County is much bigger than Caldwell and much bigger than Surry and we have two.”

Settle said he would vote that night to approve purchasing the building in Mountain View proposed as a new EMS base. Discussion indicated the owner of the building is willing to sell.

Commissioner Brian Minton said he also would vote to buy the property in Mountain View that night.

Commissioner David Gambill, “We have come a long way with Wilkes EMS, including going to 12-hour shifts.” Gambill said he supported relying on options recommended by Wilkes EMS.

Commissioner Gary Blevins asked about the role of volunteer fire department first responders in providing rapid assistance, even though they aren’t trained to the same level as Wilkes EMS personnel. Pennington said first responders play an outstanding role in providing lifesaving services.

Blevins noted that he and Pennington had detailed discussions about constructing an emergency services building near the courthouse, but then a school shooting occurred in another state and the commissioners felt compelled to fund additional school resource officers.

He said he agreed with Settle, but that a comprehensive plan needed to be developed through a responsible budgeting process with known costs “and then I’ll support it and vote for it, but I’m not going to vote to buy something in Mountain View tonight.”

Elmore said the commissioners obviously realize the vital importance of Wilkes EMS and support the agency. Over a dozen Wilkes EMS and other emergency services personnel attended the meeting.

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