Emergency Medical

The city's 11 hospital emergency rooms continue to be crowded, often too full to accept patients, keeping ambulance crews off the streets where they are needed as they wait for beds to open up. But data released yesterday show that the major logjams of a year ago have not gotten worse -- and in some cases have improved slightly. "It's still a very rough situation on a day-to-day basis," said Dr. Robert Bass, director of the Maryland Institute of Emergency Medical Services Systems. Last year, there were major complaints from Baltimore ambulance crews and others about how slowly patients were being moved through city hospitals.

Stephen D. Halford, the Anne Arundel County fire chief who led the department through a landmark lawsuit and a radical name change, resigned yesterday after 28 years, the last five as chief. A former deputy fire chief, 52-year-old Roger C. Simonds, will emerge from retirement to replace him."Walking away from something you've been part of for 28 years is hard," Halford said, his voice echoing in the empty fire headquarters hallway. "This probably has been the most sentimental day of my life.

Carroll's volunteer fire companies are not violating a mutual aid agreement with neighboring jurisdictions by charging out-of-county residents for emergency medical services, county officials said yesterday.County attorney Laurell Taylor said she disagreed with Baltimore County Executive C. A. Dutch Ruppersberger's interpretation of the 1989 agreement between Carroll's volunteer fire companies and Baltimore, Harford, Anne Arundel and Howard counties and Baltimore City.Ruppersberger said Carroll's new policy of charging for emergency medical services violates terms of the agreement, which specifies that the jurisdictions would not charge each others' residents for services.

Imagine donning 100 pounds of gear -- boots, heavy canvas pants and coat, a helmet, an oxygen mask and tank -- and climbing a ladder, or dragging a wet fire hose through mud and gravel.Suzie Warehime, 21, has done all that and more in earning 1998 Firefighter of the Year honors from the Lineboro Volunteer Fire Company."I just like helping people," the Manchester resident said.Warehime joined the Lineboro company in January 1996 after a friend, Robin Spertzel, extended an invitation."I had been thinking about it for a while," said Warehime, noting that her father, mother and brother have been volunteers for years.

Two Carroll County fire companies are likely to join 11 others and begin billing for ambulance services, after officials learned that collecting the fees would not jeopardize their tax-exempt status.Since January, 11 of Carroll's 14 volunteer fire companies have been billing for emergency medical services at the recommendation of the county commissioners, who provide 90 percent of the fire companies' operating budgets.Reese and New Windsor chose not to bill. Reese feared the Internal Revenue Service would find that collecting fees violated regulations governing tax-exemptions, and New Windsor has no paid medical personnel.

Carroll County's volunteer fire companies will meet tonight to discuss a county proposal to bill insurance companies for ambulance services routinely covered by health insurance providers.If members of the county's 14 volunteer companies agree, Carroll could collect $2.1 million or more a year from insurance companies for providing emergency medical services, according to county budget supervisor Ted Zaleski.The seven-point proposal calls for the county to administer the program and pay each company "dollar for dollar" the revenue generated from emergency calls.

INDIVIDUAL DECISIONS of four volunteer fire companies to charge for ambulance runs this year underscores an inevitable change in the delivery of emergency medical services in Carroll County.Sooner rather than later, the other 10 volunteer companies will have to charge for their ambulance runs, even if the membership is divided over such fee-for-service operations. That will have a serious impact on the philosophy of volunteer fire/emergency service that has prevailed in Carroll for more than a century.

SOARING DEMAND for fire and emergency medical services in Carroll County is overwhelming the resources of the largely all-volunteer fire companies.The need is for more staff and more money to support these critical emergency services, particularly in Sykesville-Freedom District and Westminster companies, which together handle nearly half the ambulance or emergency medicine calls in the county.The number of volunteers is stagnant or in decline in recent years at those volunteer fire companies.

In a move that has infuriated and frightened emergency medical workers, Baltimore is considering turning over ambulance service to private management.Mayor Kurt L. Schmoke has instructed the fire chief to explore whether private companies can transport and provide quick emergency medical assistance to patients at a lower cost than the $8 million the city spends each year."All I'm doing is studying the issue and gathering information," Schmoke said.Schmoke said he expects proposals to go out within 30 to 60 days, and a final answer could come 60 days after that.

WASHINGTON -- Baltimore is preparing for a terrorist attack.Emergency officials will soon stockpile nerve gas antidotes, hold decontamination drills and train a medical strike team to respond to a chemical, biological or nuclear terrorist attack."

Police officials launched an emotional defense of Maryland's state-run medevac system yesterday, which faces a privatization initiative from General Assembly critics whose case for reform has been bolstered by a recent fatal crash and critical audit. A routine legislative briefing about Gov. Martin O'Malley's budget proposal to purchase two new helicopters turned into a heated exchange yesterday between the police major in charge of the medevac fleet and Sen. E.J. Pipkin, an Eastern Shore Republican who wants to require the police to compete for the job with private services.

A new proposal to create a Cabinet-level department to oversee Maryland's emergency medical services is no remedy for what ails the trauma care system. The idea, as floated by two legislators, sounds more like a grandiose prescription for trouble - and a scheme to privatize the state-run medevac helicopter service. The Maryland Institute for Emergency Medical Services Systems has come under scrutiny since a state police helicopter crashed in Prince George's County in September while en route to a trauma center.

With a fatal accident on their watch and some lawmakers pressing for cutbacks to the state police helicopter fleet that ferries accident victims, Maryland's emergency medical professionals are on the defensive. They've revised the protocols paramedics use to identify which patients need to be airlifted to trauma centers and decided to bring in independent experts to assess the system's reliance on choppers. They're trying to get ahead of any attempt by the legislature to undercut the highly regarded system.

In a move that could reduce the number of medevac flights in Maryland, state emergency medical officials announced yesterday that ambulance teams will be required to consult with doctors before deciding whether flying some accident victims to a trauma center is better than driving them to a local hospital. The change, in response to a deadly helicopter crash in Prince George's County about a week ago, won't apply to victims with obviously traumatic injuries. But the state will stop automatically ordering medevac transportation based on the nature of an accident, as it does with hundreds of flights each year.

Medics from the Howard County Department of Fire and Rescue Services are providing emergency medical and evacuation services in the aftermath of Hurricane Gustav. The four-member medic unit from the county arrived in Louisiana on Sunday and is among five units from Maryland that responded to a request for help through the Maryland Emergency Management Agency (MEMA). "The fact that we have people who have the courage and are willing to put themselves in harm's way to help others is very humbling," said county Fire Chief Joseph Herr.

A deputy slumps to the ground. "Officer down! Officer down!" Three members of the Harford County Sheriff's Special Response Team, essentially a SWAT team, corner the suspect with their guns raised. As deputies scatter to secure the living room, the fallen officer lies motionless. An unarmed man in a black Kevlar bulletproof vest rushes in. Unlike the others, he carries no weapons, just two huge black packs, loaded with medicine and supplies. The unarmed man in the practice drill is Dr. Eric Nager, an emergency room doctor at Franklin Square Hospital, who often accompanies the team in barricade situations.

A Baltimore firefighter is challenging a department rule that all firefighters maintain Advanced Life Support certification, taking his case before a federal arbitrator yesterday. The closed-door hearing involving Ryan Wenger, an emergency-vehicle driver, centered on whether firefighters who obtain a higher rank should have to remain certified in advanced-level life saving skills, a department policy that has drawn the ire of the city firefighters unions. Wenger and the head of one of Baltimore's fire unions say firefighters who become officers or drivers have added responsibilities during emergency medical calls and should not have to focus on medical care.

The city's 11 hospital emergency rooms continue to be crowded, often too full to accept patients, keeping ambulance crews off the streets where they are needed as they wait for beds to open up. But data released yesterday show that the major logjams of a year ago have not gotten worse -- and in some cases have improved slightly. "It's still a very rough situation on a day-to-day basis," said Dr. Robert Bass, director of the Maryland Institute of Emergency Medical Services Systems. Last year, there were major complaints from Baltimore ambulance crews and others about how slowly patients were being moved through city hospitals.

The radio in the emergency medical vehicle crackled - the stifling heat had overwhelmed someone on Lexington Street. Capt. Charles Cheelsman turned on the vehicle's lights and sirens and hit the accelerator. Cars swerved to get out of the way as he sped toward Lexington Market. When he got there, he found Murdis Ferguson, 52, drooping in a plastic chair. She had been walking with a friend, Celeste Gross, also 52, when she was overcome by the heat. Yesterday, the temperature hit 98 in the city, but it felt like 106, according to the National Weather Service.

Feeling faint, Jose Cintron called 911 last month. Two emergency responders soon arrived at his Joppa home. One of them - a polite young man, Cintron recalls - knelt down and checked his blood pressure and blood oxygen level. "No one ever checks my oxygen," said Cintron, 67, who has experienced episodes of low blood pressure and shortness of breath since being hospitalized for pneumonia in 2004. "He said, `I'm not a doctor, so you should check with a doctor.'" Not only was the man not a doctor, but he wasn't even an emergency responder, police say. Robert Joseph Smith, 24, of Aberdeen, was arrested this week, accused of impersonating an emergency medical technician and of theft.