Pulaski Council, Commissioners Discuss EMS Transfer Policy, Medic Availability

How to allocate Pulaski County’s emergency medical services was the subject of a lengthy discussion by the county council and commissioners Monday.

EMS Director Nikki Lowry explained the county usually has two certified medics on duty at any given time, but there are occasions when that number drops down to one. “A couple years ago, it wasn’t bad because you had intermediates who could do almost the same as a medic,” she explained. “Now, they have limited the scope, where if somebody has a cardiac arrest, all it is is CPR. They cannot do any medications. They cannot intubate. They cannot do anything other than transport.”

Because of that, Lowry wants to add a policy stating that the EMS department will not accept out-of-county transfers when there’s only one medic on duty, even so-called “emergent” transfers. However, she feared backlash from Pulaski Memorial Hospital.

Council member Ken Boswell understood the potential concerns, “If your medic’s on staff and he’s sitting at the shop and you don’t have a call, and then you turn down a call, that’s where you get the backlash from, is ‘Hey, wait a minute, your guy’s sitting there doing nothing, and we’ve got work.'”

Meanwhile, council member Linda Powers pointed out that many transfer requests are to provide emergency care to Pulaski County residents. “I just want to remind you, when you’re talking about the transfers, you’re acting like these are people that come out of nowhere,” she said. “They’re people from Pulaski County that have come to the hospital.” While Powers said most of those are emergency situations, Lowry said some of them aren’t.

Lowry estimated that Pulaski County EMS is averaging 20 to 25 transfers a month and turning down 10. Powers noted that Pulaski Memorial Hospital does also use other ambulance services, and she offered to get additional data from the hospital’s perspective.

However, the final decision to restrict transfers when the county’s down to one medic is ultimately up to the county commissioners, who appeared to support the proposal.

In the long-term, Pulaski County hopes to add more medics to its EMS staff. Council President Jay Sullivan directed Lowry to hire a certified medic the next time there’s a full-time opening in the department. Lowry felt that the county’s pay rate is competitive enough to retain staff, but not good enough to pull new medics in.