DATE: Sunday, September 28, 1997            TAG: 9709260354

SECTION: PORTSMOUTH CURRENTS     PAGE: 02   EDITION: FINAL 

COLUMN: IDA KAY'S PORTSMOUTH 

SOURCE: Ida Kay Jordan 

                                            LENGTH:   67 lines

CITY DRIVEN TO MAINTAIN AMBULANCE SERVICE QUALITY

Skepticism about the city's decision to take over the 911 ambulance service here fades in the wake of a report given last week to the City Council.

And, in view of the pending closure of Portsmouth General Hospital's emergency room, we probably should be thankful the city is directly involved in dealing with the situation.

Until January 1996, the city contracted out the ambulance service and, despite the notion that insurance and other payments from users should pay for it, the service always cost the city money. It still costs money but the net savings of $250,000 since Jan. 1, 1996, is pretty impressive.

And the quality of care has been excellent, by all reports.

Portsmouth's ambulances (three vehicles) responded to more than 10,000 emergency calls in 1996 and that number is expected to go over 11,000 for 1997. The city employees responded to 93 percent of the calls within eight minutes, which exceeds national standards.

However, Maryview's plan to close the Portsmouth General location and operate only the emergency facility at the Midtown location now prompted City Council to approve $185,702 for expansion of the department, expansion that will add a fourth ambulance to the fleet and additional employees.

Why is this necessary?

In 1996, 2,500 patients were delivered to Portsmouth General and almost twice as many as taken to Maryview. Even without the addition of those now going to Portsmouth General, there are times when Maryview goes to ``overload'' status and refuses patients.

What happens then?

The patient must be transported to another city. First choice, of course, is Sentara Norfolk General which is only a few minutes away. But that hospital too sometimes goes on ``overload.'' And probably it will be in that situation more often with the closing of Portsmouth General.

When Sentara Norfolk General emergency room is full, then the Portsmouth ambulance must seek other alternatives - DePaul or Sentara Leigh in Norfolk or Obici in Suffolk.

Going the extra distance means that an ambulance is tied up on the call longer. And that's a real problem when the city has so few vehicles, which already have a higher volume per vehicle than those in any other area cities. So it was imperative that the city add more wheels and more people to accommodate Maryview's decision to close Portsmouth General.

The training of the city employees - eight full-time paramedics and 27 part-time paramedics - is impressive. In addition, the city fire department has more than 75 firefighters who have been certified as shock trauma technicians and another 20 firefighters are in training now.

Records show that at least six lives were saved last year by quick action and skilled care in the part of the city team. Those six persons had suffered complete cardiac arrest. Not only were they revived by the time they reached the hospital. They recovered.

The city did the right thing when it set up its own emergency medical services department. Now the council has done the right thing by expanding the department to accommodate circumstances beyond the control of the paramedics.

However, the reasons for the expansion still leave me feeling uneasy about medical care here when Portsmouth General is closed.

Will people suffer as a result of ``overload'' in the E.R.? If the emergency services are that overloaded, what about the in-patient services?

Maryview officials say the numbers work; that is, if you add up patient days at both hospitals and divided by 365 days, Maryview can accommodate them. But that doesn't account for the fact that there are certain times of the year when there are more sick people than other times.

I guess we'll just have to hope for the best. And we can know that the city is doing what it can to be sure we have a ride across the water if we need it!

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