Both the public and Greene supervisors learned last week there has been an anonymous complaint made about Greene County Emergency Medical Services (EMS) regarding transport of a patient earlier this month.
“We staff two medic units every day 24/7, but those two units were committed to other calls when this third call was dispatched,” said Melissa Meador, director of Greene County Emergency Services. “It’s important to note that dispatch had contacted mutual aid for assistance; we contacted Madison County, Orange County and Albemarle County and all three of those jurisdictions denied our requested assistance.”
Meador told supervisors when she arrived to the scene in Ruckersville she found a patient who was “deteriorating rapidly.” Greene County EMS Supervisor Aaron Anderegg arrived two minutes after Meador, she said.
“We decided that we would attempt to medivac this subject from the scene,” she said. “Pegasus (air transport) was actually out of service. Pegasus has a ground transport unit, so we requested an estimated time on that and they said it’d be over 40 minutes. At that point Supervisor Anderegg turned to me and said we needed to go now.”
She said using the patient’s condition the pair made a decision to place the patient into her county vehicle and meet one of the Greene County ambulances that was returning from Martha Jefferson Hospital, which can be viewed as a violation of the Virginia Office of EMS rules. Anderegg remained in the back of the vehicle with the patient, monitoring his situation, and they had gear with them in case the patient got worse.
“You’re not supposed to transport a patient in a non-transport vehicle,” Meador said. “It is under review right now. We do not know if we are going to be cited on this or not, however I stand firmly behind the decision (we) made.”
Meador noted that the first call once the patient was transported to the ambulance was to Dr. Debra Perina, Greene County EMS Operational Medical Director.
“We have her full support on this due to the time sensitive issue,” she said. “Mr. (Mark) Taylor, county administrator, has supported us through this, as well. This is not a common practice in Greene. It’s not an accepted practice in Greene. However, we made a judgement call on a very rapidly deteriorating incident.”
The patient, Meador said, was released from University of Virginia after six days in intensive care after diagnosis of a heat stroke.
“Heat stroke has about a 40% mortality rate; it jumps to 80% with treatment delays,” Meador said. “Again, we made the right call. We recognized the signs and we knew we had to get somewhere for those custom drugs that they have in the hospital. As soon as we went into the emergency department, they had been stroke-alerted. There was no delay.”
Board of Supervisors Chairman Bill Martin said the entire board stands behind their decision, as well.
“You put the patient first,” Martin said. “So, the board has collaborated on a brief statements that they’ve asked me to read on their behalf and supportive view: The Greene County Board of Supervisors acknowledge that the emergency medical services incident at the Market on July 6 at 4:50 p.m. was unusual and required the use of good judgment. When Ms. Meador and Mr. Anderegg exhausted all transportation options—Greene County, Madison County, Orange County, Albemarle County and Pegasus air and ground units—they put the patient’s care first and transported the patient in Ms. Meador’s Command vehicle, which is a county vehicle, part way to the hospital with while Mr. Anderegg maintained patient care. The Board of Supervisors strongly supports the decision made, even though a technical violation of state Office of Emergency Medical Service regulations occurred, because of the best interest of the patient.”
At the end of the meeting, Monroe Supervisor Steve Bowman asked Taylor if he would draft a letter to UVA and Martha Jefferson hospitals, expressing concerns about better voice data and video communications between an EMS provider in the field and the emergency department.
“Communications between the paramedic and the hospital is a problematic issue, particularly for rural entities,” Bowman said.