MOSCOW -- The survival rate of patients with out-of-hospital cardiac arrests in Moscow is virtually zero, compared with national averages of 20 percent.
So concludes an Emergency Medical Services Task Force report presented to the Moscow City Council this spring.
Reasons for the low survival rates range from delayed 911 calls to slow emergency medical technician response. But rates also could hinge upon whether the ambulance is staffed with paramedics, who are authorized to dispense medications.
The Moscow volunteer emergency ambulance company does not have paramedics. Task force members suggest enhancing the EMS program to include paid paramedics could save one or two more cardiac arrest patients a year.
"We need to build on what we've got and add paramedics," said Nick Crookston, task force chairman.
"The volunteers are doing a lot for us, but we're at the point where we need more than what we can expect from volunteers."
Dean Neufeld, a Lewiston-based consultant for Idaho EMS System, said adding paramedics doesn't necessarily mean survival rates will improve because other factors influence those numbers.
Also, Moscow's small sample -- 10 cardiac arrests per year -- may distort results.
Another concern outlined in the report is the relative inexperience of Moscow's volunteers -- 23 of 30 have less than two years in practice. Also, it seems a handful of EMTs handle the bulk of the calls, with eight volunteers shouldering 53 percent of the load.
While the task force reported its findings in April, the city council has yet to decide what to do with the results.
A survey may be needed, said City Supervisor Gary Riedner, but the council has tabled discussion about the report until work can begin on a strategic plan for the city. The earliest planning could begin is October, he said.
"It wasn't a big priority in the last two months," he said about the EMS report. So far, the city has not made an effort to distribute the 14-page summary. But Riedner said it may be possible to post it on the city's Web site or have copies on hand at city hall.
"We ought to make it more available."
Crookston said the council needs to move forward with the issue and suggests public forums at which community members could learn of EMS concerns and voice opinions about improving service.
"This issue really needs the attention of the council and the staff. The task force's work is important, but it's only the first step. We need to put some energy into it -- it's crucial it gets done."
Ambulance company services are financed entirely by donations and user fees.
It is estimated volunteer firefighters and EMTs save Moscow residents $2.5 million to $3 million a year. On top of that, insurance premiums for homeowners and business owners are reduced because of the service.
Neufeld estimated the cost of hiring enough paramedics for 24-hour-a-day service would be about $180,000, which would pay four full-time and one part-time paramedics $40,000 a year, including benefits.
In a sample questionnaire included with the report, the task force suggests adding paramedic-level service could increase ambulance user fees from $275 per run to approximately $550 per run.
Riedner does not believe Moscow's EMS needs warrant hiring a paramedic at this time.
"The volunteer EMS crew and fire department are very dedicated. It's a community service and they are committed to providing that service."
Moscow has made progress on other recommendations made in the task force report, Riedner said. One suggestion was to provide professional paramedic-trained leadership. The city is now advertising for an EMS operations officer.
The city also hired a clerk to help with paperwork EMTs must do for ambulance runs and two additional student EMTs to fill in for resident firefighter/EMTs who leave over the summer.