Fire agency anticipates health care reform will emphasize prevention

Public safety: Central Pierce expects frequency of 9-1-1 callers to decrease in the coming year

Special to the HeraldDecember 4, 2013 

Developed as a universal number, 9-1-1 was intended to be used in emergency circumstances.

The President’s Commission on Law Enforcement and Administration of Justice made a recommendation in 1967 that a single number should be used nationwide for reporting emergency situations. The first such call was made in 1968.

Today, an increasing number of the 27,000 9-1-1 calls received annually are generated by older adults, particularly those on the leading edge of the baby boomers, according to Ed Hrivnak, a nurse and an assistant chief of prevention and public education for Central Pierce Fire and Rescue.

The changing demographic is significant for emergency service providers, Hrivnak said. Addressing older adults’ needs is becoming more important.

“I am very passionate about taking care of seniors, and I want to see them living independently at home,” Hrivnak said.

The three main reasons older adults call 9-1-1 are due to chronic diseases, such as diabetes, congestive heart disease or respiratory issues, medication problems precipitated by multiple doctors who have prescribed multiple medications, or falls, Hrivnak said.

“Some people call 9-1-1 when they need a prescription refill and can’t get their doctor,” Hrivnak said. “At times, people with limited resources who can’t afford their medication have to make a decision whether to buy it or not may end up going to the emergency department. For others who have no doctor, going to the ED is their only source of care.

“One day, we were called 24 times to one facility,” Hrivnak said.

Educating the community about the appropriate use of calling 9-1-1 is one of the topics Hrivnak covers during the programs he presents at senior centers and older adult living facilities.

Everyone should plan ahead before they need to call 9-1-1, Hrivnak said. He advises people to keep good records that include a list of current medications, their health information and next-of-kin contacts.

“If someone is unconscious, we may not have any way of identifying whom we should call,” Hrivnak said. “At times, I have checked an individual’s land and cell phones to find a frequently called number, hoping that it is a relative.”

Such information can be placed on a File of Life card, which the fire department gives out. It’s designed to be placed on a refrigerator.

“Unfortunately, their use rate is low,” Hrivnak said.

The cards should be completed for everyone, not just adults, he said.

“I have them for my children,” he said.

People should have a good understanding of all of their medications, and eliminate anything that may increase a risk of falling, Hrivnak said.

There are occasions when emergency responders help to problem-solve, thus reducing the need for future calls.

For example, Hrivnak recalled receiving a call from a woman who had fallen in a bathtub.

“She was fully clothed and simply was cleaning the tub, but once she fell, she couldn’t get up,” Hrivnak said. “We both had to laugh. The solution was to install a grab bar.”

Since the 1970s, when the 9-1-1 system became more fully developed and expanded, there have been notable changes. Hrivnak believes health care reform also will impact the system.

“In my opinion, we may get more calls initially, but with more people having insurance, I envision a way to triage callers in order to provide the help they need,” Hrivnak said.

Judy Murphy, a nurse and emergency medical services administrator for Central Pierce Fire and Rescue, agreed.

“I believe that we will see many more changes in the next three to five years,” she said. “Today, we are the safety net for many people who have no regular health care. In addition, we provide information on available resources through our work with community partners, such as the MultiCare Good Samaritan’s HEROES (Helping Elders through Referral and Outreach) program.”

Murphy believes health care reform will foster a greater emphasis on prevention, thanks to more people who will have health insurance and a primary care physician.

Consequently, they expect the number of 9-1-1 calls to decrease. Murphy foresees the role of EMS personnel changing.

“We are really a mobile, integrated health care provider, and, as such, can provide services in many different ways,” she said.

Murphy said fire districts are working to formulate new possibilities.

“This is a very exciting time to be providing health care,” she said.

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