History of CCEMSLast modified: March 19, 2014
Cleveland County EMS – Past and Present
By Joe Lord, Cleveland County Emergency Medical Services Director
Before Cleveland County began serving its residents with ambulance services in 1976, volunteer rescue squads and local funeral homes provided all local ambulance services.
When the county began assisting the local rescue squads, it provided paid staff to help support the rescue squads on weekdays during normal business hours. At that time, the rescue squads needed additional manpower because most of their volunteers worked full-time jobs. Two employees were used at the Shelby Life Saving and Rescue Squad along with an additional employee at the Kings Mountain Rescue Squad. These employees supplemented the volunteer staff during the daytime and used all equipment owned by the local rescue squads.
An Emergency Medical Technician – Intermediate class was begun in 1984 – the next step for additional training for all local rescue squads and county employees. In 1986, Cleveland County Emergency Medical Services (CCEMS) was officially formed with its own full time staff and equipment. Up until that time, the services provided to Cleveland County residents were at the basic level for pre-hospital care and were provided by Emergency Medical Technicians (EMT’s) on ambulances. But during that year, many volunteers and paid county employees began to want additional training to provide more advanced care.
In 1989, more training was established throughout Cleveland County with the first Emergency Medical Technician – Paramedic (EMT-P) course. Several local volunteers enrolled in the class along with about 90% of the CCEMS staff. This extensive training required many additional hours on top of the basic provider requirements.
North Carolina requested an enormous amount of cooperation between the local hospitals for this type of service to be provided within the community. Dr. Michael Barringer was appointed to serve as a liaison between the county, the local rescue squads, the local hospitals and the state of North Carolina. This process took almost as long as the training itself, which lasted more than 10 months.
Dr. Barringer became the medical director of the paramedic program, which began with the challenge of providing coverage throughout the county in a fair and equitable fashion. While the county worked with the state to come up with a new approach to meet the specific needs of the community, other rescue squads began working with Dr. Barringer to provide these services from within their own departments.
In February 1990, CCEMS rolled out the first Quick Response Vehicles (QRV’s) in North Carolina. QRV’s are fully equipped paramedic units and have all equipment required for ambulances except for two things: a stretcher and a second crewmember. The QRV’s became the workhorses in the ambulance industry for Cleveland County during the early1990’s, allowing CCEMS and local rescue squads to work together in providing the best pre- hospital care available in the nation. These types of services had previously only been used in very large metropolitan areas. Very few paramedic services were available in rural settings.
The QRV’s were used to spread the paramedics to the outlying communities and to allow the minimal number of personnel to provide the maximum amount of coverage for an 465 square-mile area. Paramedic services were provided by seven QRV’s located in many communities within Cleveland County. The response times were well within the national goals of 8 minutes or less, 90 percent of the time. The services worked well with a paramedic responding to all life-threatening calls along with a fully staffed volunteer ambulance from the local rescue squads.
In the mid-1990’s, volunteer departments began having difficulties maintaining full-time coverage of the volunteer districts and the number of available volunteers declined over the next couple of years. The volunteers had difficulty trying to hold down full-time jobs and volunteer at the same time. CCEMS hired additional staff to maintain the emergency medical service coverage that communities had been accustomed to in the past.
CCEMS became the first agency in North Carolina to create and manage an electronically recorded database that was created in-house. This has been a program that several other counties and a federal agency have adopted for their own use. Several trade journals covered the event when we first started our electronic database more than six years ago. Currently CCEMS has worked with the state in creating an electronic database for the entire EMS system across North Carolina.
In 1995, another form of ambulance transportation was being requested from within the community: Medical facilities wanted a higher level of care since a majority of the acute injuries and accidents required specialized care facilities. For example, almost all spinal column or brain injuries required specialized care and after the initial treatment by local medical facilities, it became necessary to transport these individuals to regional facilities specializing in acute care injuries and illnesses. Several larger medical facilities began initiating transports that were considered Specialty Care Transport Units. Cleveland Regional Medical Center (CRMC) realized the need for these services to be local and helped develop the level of services within CCEMS to the current Specialty Care Transport Units that we currently have.
To maintain these units, additional training was necessary to eliminate the need for hospital physicians and nurses to accompany the ambulances for transport. Currently CCEMS contracts with Cleveland Regional Medical Center to provide these services to patients needing additional care while being transported from one medical facility to another. This service frees up hospital staff so that they are not so short handed when these needs arise. Today CCEMS transports approximately 800 patients a year at the Critical Care level.
Throughout the late 1990’s more and more requests were made from rescue squads for CCEMS to provide full-time staff. Currently CCEMS staffs nine Critical Care Paramedic ambulances and three QRV’s during normal peak times. A maximum of 19 staff members are available for field operations at any given time. The crews work 24 hours on duty and 48 off.
CCEMS is diversifying its staff work and trains with other agencies as needs arise. Employees are taking added courses on all levels of rescue techniques. Our educational staff is developing continuing education classes on compact discs for distribution to outlying bases. The next phase is to streamline video production and plans to are to produce instructional DVD’s. CCEMS is involved in a consortium of N.C. counties to network on training issues.
For more than five years, CCEMS has purchased needed materials needed in bulk to save money. Now, several Cleveland County agencies obtain their equipment through the CCEMS. CCEMS also purchases materials for several surrounding counties, saving money for all involved. Computers have been a mainstay with CCEMS. Since 1993, the department has developed many software programs for its specific needs – from tailoring the payroll to the ordering of uniforms to handling communication needs to creating public- relations materials. Last year, CCEMS received four grants, and we are continually seeking additional ones as well. All grant funds go back into the community for prevention programs, such as the National Safety Town Center for the younger folks to the Automatic External Defibrillators (AED’s) to help those who have had a heart attack.