First responders establish new guidelines as freestanding ER opens doors in Steamboat
December 7, 2017
STEAMBOAT SPRINGS — First responders in Steamboat Springs have set new protocols for providing ambulance service in the wake of the opening of Steamboat’s first freestanding emergency room.
"Freestanding ERs are not a new thing,” said Steamboat Springs Fire Rescue Deputy Chief Chuck Cerasoli. "The Denver metro area operates under one protocol, so I reached out to a gentleman who works for the Colorado Department of Public Health and asked if they had any information on how other places were handling it. He referenced and then sent me the Denver metro area protocol, and I took that and adapted it to our area and our situation."
He said patients who find themselves in the back of an ambulance should know that procedures are in place, and crew members are looking out for the needs of patients.
"We want to do what is in the best interest of the patient, and having only had one facility that could take care of emergencies and really deal with our patients, the choice was not there. It was very straight forward,” Cerasoli said. “With another one opening, it offered options and a lot of questions started arising — what is their level of care, what is their ability and what does our medical director want us to do?"
The internal procedure outlines where patients will be taken based on their individual medical needs when they need an ambulance. Steamboat Fire Rescue will use UCHealth Yampa Valley Medical Center as its default, and if patients prefer to go to the Steamboat Emergency Center, they must make crew members aware of that choice.
Cerasoli said the department worked with Laila Powers, the Routt County medical director, to establish the process.
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"It's not necessarily a policy, although it might develop into a county protocol," Cerasoli said. "But right now, it is just a guidance procedure for our staff.”
Patients with significant trauma, abnormal or unstable blood pressure, women who are more than 20 weeks pregnant, patients who have suffered a heart attack, stroke or or signs of other life-threatening illnesses will be taken to Yampa Valley Medical Center as well as post-cardiac patients. Psychiatric patients or those who are under the influence of drugs or alcohol will also be transported straight to YVMC.
Cesasoli said that doesn't mean the new emergency center can't handle these conditions, but that the Yampa Valley Medical Center has capabilities, including an operating room, that allow doctors to address all of these issues. Yampa Valley Medical Center is a level 4 Trauma Center and is currently in the process of becoming a level 3 trauma center.
The Oak Creek and Hayden fire protection districts are still in the process of forming an internal procedure relating to ambulance calls and would work with Powers on the details of an effective plan.
Captain Roger Moore in Oak Creek said his ambulance crews currently transfer patients to Yampa Valley Medical Center as does the department in Hayden. Yampa and Hayden ambulance crews will sometimes transport patients to The Memorial Hospital in Craig or Vail Health if those facilities are closer.
Cerasoli said the ambulance will provide transfers of patients from the Steamboat Emergency Center to Yampa Valley Medial Center when requested. However, the service will require a physician certification statement from a physician at the hospital.
Steamboat Fire Rescue will transfer patients from Steamboat Emergency Center to the Steamboat Airport as requested. Once again, a physician certification statement must be completed and signed.
Cerasoli said it is rare for the ambulance to transfer any patients outside of the county. He said in cases of immediate medical need, where timing is critical, the ambulance service may be used to transfer patients to a hospital. He said in most cases, air service is used, but he said there have been rare occurrences in the past when weather prohibits that air transfer, and ground service has been required.
He said staffing is a key factor in those transfers. Steamboat Springs Fire Rescue has four ambulances with two of them staffed fully 24 hours a day.