SVAC Shortcomings, Future Debated at Council

Heidi Zemach for SCN

The Seward City Council heard two starkly contrasting presentations from Seward Volunteer Ambulance Corps, or SVAC members Monday night regarding the care that the Seward Volunteer Ambulance Corps currently provides, and how it could be upgraded in the future.

The all-volunteer ambulance corps responds to emergency calls, provides needed care to help patients and stabilize their conditions well enough to transport them to higher level care facilities such as the nearest hospital (Seward Providence Medical & Care Center), or to the nearest emergency Life-Flight transport. The corps operates both inside city limits, and outside to Seward Highway mile 38, the “Y” at Tern Lake.

SVAC volunteer Randy Rydberg, who is trained as a Mobile Intensive Care Paramedic, gave a power point he had created outlining the problems he sees with the small, rural care provider model, and proposing some radical solutions. His own paramedic license is expiring in December, and he’s leaving the field after 36 years, most of them in larger cities than Seward.

SVAC adheres to Alaska State Standards and does not, and cannot provide the same quality of emergency care that is considered the National Standard of care in cities Outside because of slower response times, the lack of manpower, advanced professional medical training, the number of services and medications provided, Rydberg said. The corps also lacks some commonly used medical diagnostic equipment.

SVAC’s average response time inside the city is about seven minutes, he said. But if the emergency is beyond the city limits, it can range anywhere from 10-30 minutes or more, depending on where the volunteers and the emergency happen to be. Everybody knows that time is of vital importance to brain cells and cardiac muscles in cases such as stroke or heart attack, he said.

He gave some examples of the limitation of services that SVAC E.M.T.s provide. A patient who is experiencing a seizure would receive oxygen and IV fluids, but not standard medications typically used to stop the seizure, he said. A patient undergoing a severe asthma attack, who is panicking, flailing and desperate, would not be sedated or receive paralyzing drugs or intubation by SVAC E.M.T’s. Someone suffering a heart attack will receive oxygen, aspirin, nitroglycerin tablets, IV fluids, EKG monitoring, but fewer procedures would be available than those offered under National Standards, he said.  SVAC does not carry, nor provide morphine to heart attack victims.

Due to the relatively low number of calls to respond to compared to that of big city ambulance workers, Seward SVAC volunteer’s skills grow rusty on certain procedures, and their level of training is lacking when it came to performing certain basic procedures such as reading 12-lead heart monitors, or putting IV into bones, he said.

Rydberg had not shared his presentation, nor his own recommendations with the corps’ president prior to the council meeting, and it took the rest of SVAC completely by surprise, they said. It was a harsh assessment that the other dedicated longtime volunteers felt slammed the corps, slammed them, misrepresented their abilities, and devalued the hard work that they do for no pay, and at great personal cost.



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“I’m trying to catch my breath!” said SVAC President and longtime volunteer Mike Moore after Rydberg finished. He added that it was hard to sit there and “get slam dunked” publicly, and not be able to criticize his colleague’s presentation as he had been told not to do.

“I just don’t know how to say it to you,” Moore said. Since 1953, corps volunteers have saved many hundreds of lives, and done a great job; “I think we’ve really got a good organization and some really good people,” he added.

SVAC does not carry certain drugs like Morphine as it is a Class One narcotic, and SVAC would have trouble properly securing it in an open, all-volunteer facility such as the corps operates, according to state required safety standards, Moore said. In his 27 years of responding to emergencies here, there have only been two call requests for morphine, he added.

As for being short staffed, Moore said it’s always been difficult to have volunteers on call for at a minimum of two, 12-hour shifts a piece, and their training and re-training requirements for E.M.T’s are increasingly extensive—especially for volunteers. But early on the corps had 12 members, and although it rose to 25 at one point, incredibly, it still has 12 people filling the ranks. Plus, three more interested volunteers showed up at their last meeting, he said.

“Manpower is always an issue, (but) I think we are trained better than Ryberg led people to believe,” SVAC 32-year volunteer Sue Schmidt told SCN later. “We (E.M.T-3s) are trained in reading EKGs. We are trained to recognize and treat lethal arrhythmias, and we spend quite a bit of time learning this stuff. Several of us have gone other places and taken training in it.” SVAC members also are, in fact trained and skilled at getting an IV straight into a bone, she said, despite Ryberg’s claims to the contrary.

Another point of contention between Rydberg and the others at SVAC was whether Seward is ready to start paying trained paramedics to provide ambulance service for a community of this size. Emergency service would be significantly improved if the city hired two or three full-time paramedics, folded them into the Seward Fire Department, and had them augment the existing group of SVAC EMT volunteers who respond to emergencies, Rydberg said. The city also should also acquire two new well-equipped SUVs to transport patients, and acquire more extensive lifesaving equipment, including 12-lead heart-monitoring equipment. He also suggested the corps establish a better working relationship with Providence wherein the hospital would recognize the corps individual’s training and expertise, allow the corps access to certain meds, and offer joint community health education, training and screenings. While acknowledging its high cost, Rydberg said it was a matter of priorities, and whether improving such care to ones’ own friends and neighbors would be worth the increased cost.

SVAC President Moore admitted he wouldn’t be surprised if the Seward community would demand paid paramedics to complement existing ambulance services after growing  another 10 years. But for now, the corps is simply getting by the best it can, he said.  The corps has kept purchasing new ambulances based on need, donating their used ones, and is considering purchasing some of the costly monitoring equipment to supplement their own. The Life-packs cost $75,000 apiece when last priced, however, and there are all sorts of costly add-ons that are recommended for each piece of equipment purchased. To the council’s offer to help the corps obtain state-funded equipment, Moore replied that his corps members tend to be singly old-fashioned and independent-minded, and they prefer to purchase their own equipment and ambulances.

Seward Fire Chief Dave Squires told the council he’d fight “tooth and nail” against Rydberg’s proposal to add full-time paramedics to his department. The city fire department’s duties only extend out to the city limits, while SVAC regularly responds to emergencies all the way to mile 38. Unless borough residents voted to pay the city for paramedic service in their areas, with their own property taxes, he did not feel the city should bear the additional cost, Squires said. His staff has more than enough work to do already, and should not be expected to take on that additional burden.

Alaska has adopted different standards of emergency care than the rest of the nation due to its geographical remoteness, Schmidt said. Having just researched the ambulance corps of other Alaska communities the size of Seward, she could find none with paid paramedics. Moving to a system of paid paramedics would be extremely costly for Seward, and she believes would undermine the corps’ spirit of volunteerism—especially if paramedics hired from Outside are employed here, and get to be first in line to do the procedures that volunteers have taken their personal time to get trained to do, Schmidt said.

 

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16 Comments

  1. If the average run time is only seven minutes, maybe it makes more sense to “load and go” than it does to sit on the scene with a bunch of costly diagnostic equipment. If someone is having crushing chest pain, is sweating bullets, and having trouble breathing, is a 12 lead EKG really needed? And more importantly, how is a 12 lead going to change your treatment plan?

    Our SVAC volunteers do one heck of a job. Thank you all for your hard work and dedication. I hope I never have to call upon your services, but I’m secure in the knowledge that you are there if needed.

  2. WOW a sneak attack and retiring in Dec? I hope our fine folks at SVAC don’t think we don’t appreciate or support them. Kudos to those who give their time for others.

  3. I have the up-most respect for the volunteers, They make numerous calls to the cruise ships when they are in town, Maybe the council should give the money to SVAC that they are considering giving to the railroad.

  4. Eric Landenburger says:

    I’ve never had occasion to use SVAC, but it’s a great confort to know that it’s there if my family were to have an emergency. I want to extend a hardy thanks to all the volunteers who donate countless hours making the SVAC a reality. Sure, everything and everybody can be improved on, but I’d be very cautious to criticize such great folks – the alternative of not having the SVAC is not very attractive.

  5. I’ve not had to use SVAC personally but I have seen them in action and I want to thank them from the bottom of my heart for the incredibly important service they provide. We appreciate you and please keep up the great work. The same goes for BCFD and the SVFD. People who although I do not know them they hold a special place in my heart.

    I do know Mr. Rydberg and in an attemt to defend the SVAC and not completely revealing who is really is I will say this. He rode into town a while back with stories of heroic accompolishments in past life. I have winessed nothing that makes me believe that any of it is true. I wouldn’t put to much stock in any of his opinions.

  6. Keith Campbell says:

    I do not know Mr. Rydberg but having interacted with the Corps for over 40 yrs. the service and dedication is outstanding. The envey of many other Ak communities. If you want Seattle response time move to Seattle.

  7. What sad and vindictive way to choose to retire. To besmirch the good people of SVAC, especially after some of them, including Mr. Moore, have shown Mr. Rydberg such good will over the past few years. We, everyone from mile 38 to 0 have A LOT to be grateful to the SVAC for ~ a 100% volunteer organization that is on call 24/7, 365 days a year. When the tones go off, someone comes, someone ALWAYS comes! Perhaps someone would gift Mr. Rydberg a copy of “How to Win Friends and Influence People,” for Christmas. He sure missed the mark on this.

  8. I don’t know if the people or business comunity of Seward realize how much money in taxes the volunteers have saved them over the years, it is significant! We tend to take these folks for granted. Unless you have been there you have no idea how much time and effort go into making these organizations work. It is adventageous to the community and SVAC to not accept government funds. Where there are purse strings there are puppet strings. SVAC is a great organization with dedicated local and caring people, exempt from the politics, mundane policys and budget fiasco that is associated with government. If the city (and borough) really want to help these organizations, do so by offering tax incentives to business’s that employ and allow volunteers to respond. This may not completly alleviate the problem of recruitment but it would be a start.
    My hat is off to those of you who volunteer and make our community a better, safer and more affordable place to live.

    • I do not know enough about SVAC to make a measured decision but why wouldn’t SVAC want government funds? Wouldn’t more money buy more good stuff, maybe pay one of our over-volunteered volunteers a salary? Not trying to stir up the dust at all, just interested in SVAC’s success.

      • Hi Evan, there are very good reasons for not taking government money. The decisions they make are kept out of political realms by staying independent. These volunteers give 2 shifts (at least)per week of their time for us. They couldn’t do it without the cooperation of their employers. The corp is in many ways a community endeavor and are lead by some of the most altruistic and generous people I have ever had the privilage to work with. They know exacty what they need, with all due respect.

        • I’m totally 100% in support of SVAC, just like you. I’ve had an occasion to receive their expert and speedy care so don’t get me wrong. (I even ran with them years ago). You make a good point that they know exactly what they need. But I’m still unclear about the negatives of getting government money. You mentioned staying independent which I guess I can see, but would a salary and some new equipment threaten that?

  9. Well said Monty. How about a sales tax exempt card for fuel for their vehicle?

  10. So no one in Seward is concerned that if their child were having a seizure the ambulance crew couldn’t give anti-seizure medication?

  11. No, not at all. Load and go. The golden hour is exactly that…get the patient to definitive care asap. I don’t see the doctors calling for a need for this.
    This is the finest ambulance corp I can imagine and they do it for us free of charge. What this rabble rouser has done is unnecessary and for us to continue to pay attention to this gives him credence.
    The Seward Volunteers are my heroes.