The Winchester Star, Thursday, August 1, 1985
Towns Consider
Regional Service
Page
BV EIU(' BEOM
Last week, Winchester Selectmen
and Town Manager W. Chadwick
Maurer met with representatives of
a medical consortium and the state's
firefighters union to discuss possible
alternatives to the town's current am¬
bulance program.
The town, along with nearby Arl¬
ington, has an ambulance program
that is administered by the local fire
department.
The North Suburban Emergency
Medical Consortium — composed of
Winchestr Hospital, Choate-Symmes
Health Services Inc. and the Lahey
Clinic — hopes to treat serious
trauma patients in a 10-town region
that includes Arlington.
The consortium will offer a
paramedic-driven ambulance to Arl¬
ington and Winchester. Tlie rest of the
region will be offered a paramedic-
driven Bronco that is not capable of
transporting patients to the hospital.
Paramedics — a type of emergen¬
cy care professional — are more ex¬
tensively trained and equipped than
Emergency Medical Technicians
(EMTs) who drive Winchester and
Arlington ambulances.
The paramedics must receive 1500
hours of training before they are cer¬
tified by the state to "bring an
emergency room to the scene."
While all principals agree Advanc¬
ed Life Support (ALS) treatment
would be beneficial, there is some
concern about whether the am¬
bulance will hurt existing programs.
.Affect on Town Programs
Currently. Arlington and Win¬
chester both have ambulance pro¬
grams administered by their fire
departments. The towns receive
money from insurance companies
each time the ambulance transports
a patient.
If a consortium vehicle carries the
patient, the town will not be paid.
"It could be a question of jobs. I'm
not sure." says Anthony Bonhomme,
president of the p-irefighter's Associa¬
tion of Arlington. "It's relatively new,
and there's a lot of questions to be
asked and to be answered."
He suggests a two-Bronco system
might serve the towns equally well
and ensure the integrity of the current
ambulance system.
Arlington's Board of Selectmen
and representatives of the consortium
have each promised that the ALS
system will not replace existing fire
department services.
"It is in no way intended to replace
existing services, and it, in fact, can¬
not," says Neil Stroman, consortium
chairman. "It [the new am¬
bulance 1 can't make as many runs as
the Basic Life Support (BLSl am¬
bulance can." he adds. "It is sup¬
plemental.
"You're comparing apples and
oranges. There's a difference in
capabilities between the two
systems."
ALS Capabilities
"Basic Life Support can transport,
but it cannot do definitive life support
at the scene,'' Stroman says. "It can¬
not stabilize a patient."
Paramedics have the equipment
to be in constant contact with the
hospital, and the physician on the
other end of the line has authority to
prescribe more advanced medical
treatment than current ambulance
drivers can implement.
ALS personnel can administer in¬
travenous solutions, transmit EKG
readings to the hospital and shock a
patient's heart back to life with a
defibrulation machine.
Ambulance drivers now serve a
"maintenance" role, offering few
measures to improve the state of the
patient's health, according to
Stroman.
"The whole system is good,"
firefighter Bonhomme says. "We're
not against ALS. We think it's great,
in fact."
"For certain types of patients, you
improve their chance of survival
[with ALSl," Stroman says.
Nationally, Basic Life Support
revives 6 percent of heart arrest pa¬
tients while paramedics bring back
20.35 percent, according to the state
office of emergency medicine.
Program Costs
Although most agree the ALS pro¬
gram would be helpful, the program
is not without costs.
Towns will have to replace lost
revenue when the ALS ambulance
carries a patient to the hospital in¬
stead of the town vehicle.
For Winchester, preliminary
figures show the cost of taking so¬
meone to the hospital in an ALS vehi¬
cle would be $250 a trip, much more
than the current service cost of $65.
Arlington would see such a dif¬
ference as well, but it would be worth
the money for those carried by the
ALS ambulance, according to
Stroman.
He says that even this higher
figure for ambulance runs will not
meet the costs of the ALS program
"The system, given present rein
bursment, will lose money," he says
According to Stroman. the short
fall will be picked up by the consor
tium hospitals and Armstrong
Ambulance of Arlington — the com¬
pany which will provide the ALS
vehicle.
Stroman says the hospitals are
willing to take the loss as a service to
the public.
Armstrong — which will take one
of its 18 ambulances out of service for
the program — says it will also take
a loss on the venture as a service to
the community, according to Bruce
Wallace, operations manager for the
company.
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