Beach firefighters up against city hall

VIRGINIA BEACH _ At 10:11 a.m. Wednesday, Virginia Beach firefighters listened as emergency dispatchers called for an ambulance to help a woman bleeding from the head. 

 But no city ambulance was available. 

 Three minutes later, 911 dispatchers broadcast another emergency call for a man having a heart attack. 

 ``No available ambulance at this time,'' the dispatcher said. 

 At 10:28 a.m., a third call came in. A pregnant woman was hemorrhaging badly. 

 The five or six ambulances in service that morning were on other calls. 

 ``We do not have any more rescue units available at this time. Zero rescue units,'' the dispatcher said. ``We're trying to get someone out. . . . I need to get somebody rolling.'' 

 Ultimately, firefighters cross-trained as paramedics were sent to those medical emergencies. But city policy sharply restricts what some of them can do in those critical situations. 

 Despite their training, some firefighter-paramedics can't provide advanced life support -- giving drugs or inserting a breathing tube -- because they aren't affiliated with a Beach volunteer rescue squad, as the city's policy requires. 

 Virginia Beach is the only city in the region with such a restrictive policy. 

 Even Beach firefighters affiliated with rescue squads in Portsmouth, Chesapeake or other areas can't perform life-saving medical procedures while on duty at the Beach. 

Angered, they are waging a grass-roots campaign to change that. 

 Members of Virginia Beach Firefighters Local 2924 have attended about a dozen neighborhood civic league meetings during the past few months to drum up support. They plan to attend 50 such meetings and gather 10,000 signatures on petitions to convince the city that changes need to be made. 

 City officials said that by requiring firefighter-paramedics to be affiliated with rescue squads, they can be sure they are familiar with the city's rules and policies. 

 And while city officials claim no one has died or suffered needlessly because of the policy, the firefighters union argues that it's only a matter of time. 

 City officials counter that the firefighters are using scare tactics in trying to get their message out. 

 ``I know of no situation where a delay caused any detriment to the patient,'' said Bruce Edwards, chief of the city Department of Emergency Medical Services. 

 The average response time for city ambulances, he said, is 8.6 minutes. The industry standard is 8 minutes, and city records show that Beach ambulances met that goal 90 percent of the time last year. 

 Nevertheless, at a news conference Friday, Edwards and Beach Fire Chief Gregory B. Cade said changes are in the works. A task force will look at the issues, they said. 

 Firefighters have a long list of concerns they want the city to address, but they are focusing mainly on these: 
 

 Currently, about half of the 50 firefighter-paramedics are affiliated with Beach rescue squads. Dropping the city's requirement for affiliation would immediately double the number of firefighter-paramedics able to perform advanced life support. And it would have firefighter-paramedics with those advanced skills on duty 24 hours a day, the union says. 

 The rescue squads also provide around-the-clock coverage. 

 Union members say they will take their fight into this year's City Council elections by supporting candidates who are sympathetic to their cause. 

 But the union's tactics are raising eyebrows at City Hall. 

 On Monday night, union officials told members of the Brighton-on-the-Bay Civic Association that ``they could die'' if a paramedic doesn't respond to a medical call within four minutes. 

 Union member John Anderson also talked about the two Chesapeake firefighters who perished in a blaze in March 1996. He told the crowd of two-dozen residents that staffing shortages could lead to the same tragedy here. 

 ``If we don't get there within five minutes, there's gonna be a flashover, and we're gonna have some dead firefighters,'' Anderson said. 

 City officials are incensed by the tactics. 

 ``I just don't like that kind of talk,'' said Oral Lambert, the city's chief operating officer. ``It's like yelling fire in a crowded theater. 

 ``If they're going around telling people they're going to die if such and such happens, that is disappointing public commentary coming from a professional,'' he said. 

 Union members said they want to make it clear they are speaking for the union only and not for the fire department or the EMS department. 

 In fact, they say, they are not seeking to take over the EMS department, drive ambulances or disband the volunteers. They just want to perform advanced life support duties if they are first on the scene. 

 City officials say they are addressing some of the firefighters' concerns, but that most of the issues are being blown out of proportion. 

 Edwards said new fire trucks being purchased by the city are equipped to carry drugs, and Cade said he has requested money from the City Council for 54 new firefighters this year. A request last year for 65 new firefighters was denied. The department has about 360 firefighters. 

 But Edwards said there is no plan to change the policy that requires firefighter-paramedics to be affiliated with Beach rescue squads. Besides, he said, all that affiliation means is the firefighter signs a piece of paper saying he is part of that rescue squad. The firefighter does not have to perform any volunteer work, but he would have to go through Beach rescue squad training. 

 Ed Brazle, an EMS spokesman, said the requirement is necessary because the Beach conducts its own paramedic training. Firefighters need to understand Beach policies and how to operate the equipment in Beach ambulances. 

 Medical skills and training don't necessarily differ by department. A paramedic in the Fire Department must meet the same state guidelines for training as a paramedic on the rescue squad. 

 The Beach training program, which varies in hours depending on experience, essentially is to learn skills they already have, firefighters union members said. Plus, they have to do it on their own time. By already working for and having close ties to rescue squads in other cities, firefighters don't want to be forced into membership at a rescue squad they are not familiar with. 

 ``That way, we all operate under the same procedures. It's a level field,'' Brazle said. 

 Union members say the city's restrictions are causing delays in treatment during the crucial first four to 10 minutes after arrival, which can mean the difference between life and death, the union says. 

 They point to Wednesday's overload as a prime example. 

 Israel Medina, a firefighter-paramedic, responded to help the heart-attack victim. But there was little he could do for the man. Though trained as a paramedic in advanced life support and affiliated with a Beach rescue squad, he had no drugs on his fire truck. 

 ``I didn't have what I needed,'' he said Friday. 

 Another firefighter-paramedic responded to help the pregnant woman. Though trained as one of the elite Nightingale helicopter paramedics, Beach rules prevented him from giving her drugs or starting an IV because he's not with a Beach rescue squad. 

 ``All he can do is give her oxygen and take her blood pressure,'' said firefighter Mike Barakey, a union member who was listening to the radio call while off duty. 

 None of the patients died before they got to the hospital, firefighters said. But Medina said it took 16 minutes from the initial call for an ambulance to arrive to help the heart-attack victim. 

 ``If we don't get to you within 10 minutes, you might as well call a cab,'' said firefighter-paramedic Tim Riley, another union member who also heard the call while off duty. 

 City officials said the high number of medical emergencies Wednesday was an aberration. 

 During a 1 1/2 -hour period that morning, Beach dispatchers received 13 medical calls, but had only eight ambulances, Brazle said. At least two of those were out of service, according to city dispatch records. 

 Dispatchers had to call additional volunteers who weren't on duty to staff more ambulances. Dispatchers also called paramedics in Norfolk to help with the Beach's emergencies. 

``We need to reassure the public that this is not a cause for alarm as far as public safety is concerned,'' Lambert said.