Nevada County Picayune and Gurdon Times Newspaper Archive

New Guidelines May Cost Lives

By JOHN MILLER

A proposed rule by the Health Care Financing Administration (HFCA) could spell disaster for many people.

According to the proposed HFCA ruling, ambulance services with paramedic care wold not be allowed to use their advanced live support equipment and training on patients with convulsions, seizures, coma, unconsciousness, open wounds to the eye and instantan eous death.

Chad Cornelius, owner of the Nevada County Ambulance Service, said this will severely restrict the care the paramedics can give patients at the scene, and could possibly result in the unnecessary loss of life.

He said all runs made by the NCAS don't involve dealing with life and death situations, but when they occur, the paramedic training the employees have undergone helps to insure the patient gets the best possible care until they reach a hospital emergency room.

By not being able to use the advance live support knowledge they have, the care the workers can give to the patients would be greatly restricted, he said.

Currently, paramedics can provide as much or more medical attention as a registered nurse. This includes the ability to administer drugs at the scene, operate heart equipment, including the vital defibrillator during coronary arrests, perform tracheotomie s to open clogged airways in the throat and handle punctured lungs.

Cornelius handled the first three codes, or calls when patients didn't have heartbeats, when the Nevada County Hospital closed two years ago. When these patients arrived at the hospital, he said, all had pulses.

But, under the HFCA rule, these patients could have died because of the "instantaneous death" clause in the ruling.

Cornelius said there are several occasions when a person's heart can be restarted and the patient revived if they get the proper treatment soon enough.

In fact, he said the survival rate for NCAS patients has been very good. The service has been making more than 100 runs a month, with many of them requiring some type of medical care for the patients involved.

Helen Benton was recently transported to the hospital with a heart problem by the NCAS. But, had the HFCA ruling been in effect she could have died if the paramedics weren't allowed to perform ALS on her to keep her stabilized.

The HFCA ruling also wants ambulances to go further distances in less time. This could result in unsafe driving practices if the ruling is adopted. Currently, Cornelius said, officials don't want ambulances exceeding the speed limit by more than 10 miles per hour.

Ambulance services are under the authority of the Arkansas Department of Health and the National Registry of Emergency Medical Technicians. These entities provide the regulations ambulance services operate under.

Cornelius said if the HFCA rule is adopted there will be conflicts with it and the governing agencies.

"I don't know what will happen," he said. "I'm afraid if ambulance services aren't able to get reimbursed for advanced procedures they'll go back to offering basic services."

This, he said, means patients will be given a blanket and oxygen while being transported to hospitals.

As it is, Cornelius said, Congress is trying to cut what ambulance services can be reimbursed for under the balanced budget act. Lobbyists for ambulance services are fighting to keep this from happening, though.

Cornelius said people need to contact their area legislators, Senators and Congressmen urging them to fight the HFCA proposed ruling and make sure it is not adopted.