Director: City ambulances are well positioned

Making Kalispell's north fire station the primary ambulance facility should not affect the quality of emergency care to southern Kalispell, according to the city Fire Department's medical director.

The City Council on Monday discussed how the ambulances are stationed. Dr. Richard Briles, the department's medical director, submitted his observations in a letter to the council.

In March, Kalispell opened its second fire station in northern Kalispell.

Three ambulances, two engines, a ladder truck, six firefighters and the shift captain are at the north station. One ambulance, one engine and three firefighters are at the downtown station. That is assuming one or two firefighters on a shift are not on leave or missing for other reasons.

The three north-station ambulances are the main medical response vehicles, and the one downtown is a backup.

Some residents and council members voiced concern about having north-end ambulances be the primary responders to southern Kalispell medical emergencies.

The department is the only one in Montana in which all firefighters are also trained paramedics. With seven to nine firefighters and one shift captain on duty at a time, the department can operate four vehicles simultaneously. Because one manned fire engine always must be available, that means three ambulances can be operated at a time before off-duty firefighters are summoned to drive the fourth ambulance.

Fire Chief Randy Brodehl said the three primary ambulances are concentrated at the north station next to Costco because:

. The majority of ambulance calls come from the northern half of Kalispell.

. The Kalispell-Flathead County emergency dispatch center is not equipped to keep track of which station has available ambulances for the next calls. The short-term solution to that problem is to keep the three primary ambulances in one place. The dispatch center's administrative board is looking at the equipment shortfalls.

If a medical emergency occurs in southern Kalispell, the first emergency vehicle responding to the call likely would be a fire engine from the downtown station. That prompted much of the concern about medical responses to southern Kalispell.

In his letter, Briles said an emergency run consists of three stages - going to the scene, doing medical work at the scene and transporting the patient to a hospital.

Because Kalispell's fire engines have the same medical equipment and paramedics as its ambulances, a patient would get the same help at the same speed with either a fire engine or an ambulance in regard to response times and on-the-scene medical help, Briles wrote.

However, fire engines cannot transport patients.

In a transport situation, an ambulance likely would arrive five to 10 minutes after the fire engine, Briles wrote. But any case requiring transportation also would need several minutes of on-the-scene work to stabilize a patient and prepare that person for transport.

By the time that is done, an ambulance would be present, and no overall time would be lost in getting the patient to a hospital, Briles maintained.

Kalispell Fire Department handled 4,350 calls in 2005, the most of any fire department in Montana. That's because Kalispell provides ambulance transportation service for a significant part of unincorporated Flathead County, Brodehl said.

Briles wrote that the city needs to add six firefighter-paramedics - two per shift - to staff the fourth ambulance and better serve rural areas when the fire department is swamped.

Brodehl hopes to ask for extra firefighters when the City Council tackles the 2006-2007 budget, but said that request will depend on whether money is available.