Boundary Ambulance rolls with the changes

BONNERS FERRY — For Adelle Ward, when the call went out that she needed an ambulance, her life hung in the balance. Boundary Ambulance Service responded, and thanks to changes that were made a few year ago, she had the best chance to survive. More than just alive, Ward says that she is no longer afraid.

“I felt very safe,” said Ward. “I was very sick and very afraid of what was happening to me, but they were so professional.”

Boundary Ambulance Service Chief of EMS Jeff Lindsey started as the Deputy Chief in April 2015, becoming the Chief a year later. From the time he started, he implemented changes that may have gone unnoticed by many, but not by the people who have needed their care.

Boundary Ambulance is the oldest active ambulance in the state of Idaho, having been established in 1965. It has served its county well, but continues to change with the times and the growing community. It is still a not for profit organization, but it is no longer entirely volunteer based.

“Sometime around 2011-2012 they decided that they wanted to look at the potential for bringing ALS paramedics into the county, because up until that time, they had been leaning on places like Bonner County EMS. They have paramedics,” said Lindsey. “They would bring them up, they would bring up other ambulance services out of the area to transport people out of the hospital that needed a higher level of care, that the ambulance service at the time did not provide.

“When a patient is having a time sensitive emergency, time is not on the side of the patient,” explained Lindsey. “We want to be able to bring time back to that patient.”

To accomplish this goal, the county commissioners passed an ambulance taxing district, which created the ability to get tax funds to sustain an ambulance service.

“The commissioners saw the need for the paramedic level of service that was needed in this community — especially in a rural community because you are not close to a place to get a patient to a what we consider a higher level of care, like a patient having a stroke or a patient having an actual heart attack, something like that, time sensitive or time critical emergencies,” said Lindsey.

What this has allowed is not only 24/7 coverage, 365 days a year, but there are always two paramedics on at all times. Since many of their calls involve transporting patients from Boundary Community Hospital to other hospitals further south, this means that one paramedic can aid in the transport, while another stays on for emergencies here in Boundary County.

Boundary Ambulance is roughly divided up into five categories. On the first volunteer level are the drivers, who are trained in CPR, emergency vehicle operations, radio operations, and others.

“Our drivers do a phenomenal job here,” said Lindsey. “They operate at a very professional, high level.”

The next set of volunteers are the EMT Basics, which is the first licensed level, requiring 120 hours classroom training, some clinical time, state and national level testing, background check and more.

“They can be on the ambulance with just a driver,” said Lindsey, but explained that these EMTs often learn much more than what is required of them, since they work with paramedics.

Next come the EMT Advanced, who are also volunteers. They require additional schooling and can perform additional tasks, such as starting IVs.

The next level are the EMT paramedics. There are seven full time paramedics currently employed with Boundary Ambulance. Paramedics must be licensed through the state and nationally, and require an associate’s degree. Boundary Ambulance also has two Critical Care Paramedics, which requires even more training.

“We have some of the best paramedics that I have worked around,” said Lindsey. “That says a lot because I have worked in several different places.”

Lindsey has worked as a full time firefighter paramedic, a full time hospital based paramedic, where the ambulance ran out of the hospital, and he worked in the ER when they were not running 9-1-1 calls. He has also worked in private ambulance companies, as well as county ambulance companies.

“So I have kind of seen a grand swath of paramedics and EMTs and I would put our guys and gals up, and I hold them about as high, as anybody that I have ever worked with,” explained Lindsey. “We have a good group of people.”

The extra levels of paramedics on board is what changed Boundary Ambulance in a drastic way. They are able to perform many more tasks, speeding up the process and the time it takes for a patient to receive the help they need.

Lindsey gives an example of a patient experiencing a heart attack.

“Previous to having paramedics, that patient would have gone to the local hospital. The local hospital would then have to do the EKG and all the things that we can do on the scene now, but you are losing time at this point,” explained Lindsey.

“Time being a critical factor. Our paramedics can now go to the scene. We can do the EKG there, and we can see that there is a heart attack going on,” he continued. “Once we diagnose that, then it is up to the paramedic at that point to transmit the EKG and get it to the right places. At that point it is a direct transfer to the cath lab.”

This all becomes even more critical when looking at our county, and how rural many of residents are, and how long it takes to reach them and transport them to where they need to be to receive the care that they need.

While the paramedics are crucial in the changes that have been made to Boundary Ambulance, Lindsey is also quick to point out the importance of all of his crew.

“We have got some really good skill sets of people here that I think our county is lucky to have,” said Lindsey. “The skill sets that are required for EMT Basics, and for people to keep their license level up ... it can be a stringent requirement, especially for guys and gals that are just expected to give their time.”

With the changes, not only in the growing community, but in the service that Boundary Ambulance is now able to provide, there has been a dramatic climb in the amount of work that comes their way.

“A lot of people do not realize is that our call volume since 2010, has increased about 140 percent,” explained Lindsey.

In 2010, they did roughly 400-500 calls. This year they are on pace to run about 1,200 calls, and even that number is up about ten percent from the previous year. Those calls include Advanced Life Support (ALS) transfers, medical calls, as well as being on scene for fires.

“We are toned out for everything that goes on for fire EMS in the county,” said Lindsey. “The reason we do that is because these guys come out and help us, and because we are a small county and there is not a lot of man/woman power to go around. We all pitch in and help each other out.”

While the tax fund does support some of the ambulance services, Lindsey explains that it is not near enough to support the whole operation.

“Over 50 percent of our budget comes from the work that we do,” said Lindsey.

Boundary Ambulance has a structure that is working, and the people in Boundary County are benefiting from it.

“Two year ago we only had one medic on,” said Lindsey. “It was a short time before that that they weren’t even allowed to do medic stuff. The beginning of 2015, paramedics were not able to practice in the field, they were only able to do interfacility transfers. Now in 2018 and we have two medics on 24/7.”

But Boundary Ambulance is made up of much more than trained staff and volunteers. They are people who care about their patients. They are there on often one of the worst days of a person’s life, and they are there with a kind word, a hand on a shoulder, or joke to make the patient smile.

“When I finally got into the ambulance and had been chatting with them — they have got senses of humor — they know how to do that,” said Ward about her multiple experiences with Boundary Ambulance. “They are really good. That is all I can really say because they took care of all my needs ... not only my fear needs, but my physical needs. Those go hand in hand with me.”

“It is no longer like it was way back in the old days when two guys in white coats came and threw you on a gurney and drove as fast as that truck would take them to the hospital,” Lindsey said with a chuckle.

For more information: www.boundaryambulance.org