UPDATE OCTOBER 11TH: Copper River EMS' Role As After-Hours Urgent Care Shuts Down

LETTER TO THE PEOPLE FROM COPPER RIVER EMERGENCY MEDICAL SERVICES (CREMS)  Includes Update Tuesday, October 11th, 2022 By Matt Lorenz, Coppe...


LETTER TO THE PEOPLE FROM COPPER RIVER EMERGENCY MEDICAL SERVICES (CREMS) 

Includes Update Tuesday, October 11th, 2022


By Matt Lorenz, Copper River EMS Executive Director 

Please publish the attached document in the online Copper River Country Journal.


CREMS as an organization would like to advocate for the medical needs of everyone in the Copper Basin and clarify how the loss of urgent care will affect volunteer EMS in the region, in particular CREMS. I wrote it and have permission of my board chair to have it published. 

From The Country Journal: With Cross Road's recent decision to suspend after-hour and weekend medical care, the issue of where ambulances should take patients has become critical. It's obvious that a heart attack victim might have to be Medevaced, but it's prohibitively expensive and complicated to Medevac someone with non life-threatening emergency issues. For example, many common homestead and vehicle accidents require more basic services, such as stitches, antibiotics, or just observation by an experienced medical professional. 


FURTHER CLARIFICATIONS ON CREMS SERVICES
TUESDAY, OCTOBER 11TH, 2022 


FROM THE COUNTRY JOURNAL: The Journal asked for further clarification of several sections in the letter from Copper River EMS (below). The Journal's questions are numbered. Answers by Matt Lorenz of CREMS are shown beneath each question below. 

1. Does this mean there will not be ambulance transports any more?  
 
CREMS Kenny Lake Volunteers will still provide 911 EMS response in Kenny Lake, Chitina, and Tonsina and transport patients by ambulance to CRNA and Cross Road during weekday business hours and to Gulkana Airport for after-hours/weekend rendezvous with medevac services when responders are available and feel comfortable doing so.  
 
2. Will people go to a scene only in their own cars? 
 
CREMS responders may choose to go directly to a scene as a first responder in their own vehicles.  This allows responders to avoid the additional stress and liability of transporting patients with an uncertain destination and allows responders to avoid the potential additional stress and liability of a patient who may need further care but wants to refuse transport because they do not want to be flown to Anchorage.
 
3. Will the only ambulance transport be for medevac at the airport?  
 
The CREMS Kenny Lake ambulance squad will only transport after-hours/weekend patients by ambulance from Kenny Lake, Chitina, and Tonsina to Gulkana Airport for rendezvous with LifeMed or Guardian medevac services.  On occasion, LifeMed or Guardian may pick up patients at the Chitina Airport but that is a very rare occurrence and at their discretion.  
 
CREMS volunteers will not be transporting patients to Valdez or Mat-Su hospitals by ground ambulance.  
 
4. Will there be ambulance transport by CREMS during the daytime to Cross Road and/or CRNA in the hours they are open during the 5-day week?  
 
Yes.  However, many CREMS volunteers also work and we often have more difficulty to field a crew during normal weekday business hours.  
 
'

Copper River EMS In Kenny Lake Struggles To Define Its Responsibilities As After-Hour & Weekend Medical Care Disappears In The Copper Valley 

Sign on door of Cross Road Medical Center. (Photo, Country Journal) 

From CREMS, Sunday, October 9th, 2022

Many if not most residents of the Copper River Basin are likely aware that we no longer have any after-hours or weekend urgent medical care clinic available in the entire region.

Although it is pointless to try to assign blame to anyone or any organization for this and we certainly cannot change the past, we do need to recognize that the Copper Basin absolutely needs after hours medical care in a clinical setting. The current situation is not acceptable as the long-term status quo.

EMS cannot and does not replace urgent medical care that can and should be provided locally in a clinical setting outside of normal business hours. There are important assessments, treatments, and care that require a Physician’s Assistant, Nurse Practitioner, or RN and/or also require a clinical setting.

Transporting all after-hours patients out of the area to Mat-Su Regional Hospital or Providence Valdez Medical Center by ground ambulance or flying them to an Anchorage area hospital by medevac should not be necessary nor is it appropriate for many people who need urgent medical care outside of normal weekday business hours.

This change not only affects local residents and visitors who need after hours medical care, but it also affects local responders, especially volunteers, who respond to 911 medical emergencies.

Local volunteer first responders and the CREMS Kenny Lake ambulance crew now face new and increased risks, liabilities and stress due to the lack of an after-hours urgent care receiving facility, the potential for Delta Medical Transport to be out of service while driving patients to Mat-Su and Valdez Hospitals, the potential for Delta Medical Transport to be tied up with a patient waiting for the arrival of a medevac flight, and the possibility that a medevac flight will simply not be available due to weather or limited resources.

Despite this adversity, some things will not change. CREMS will continue to actively provide and/or support EMS training throughout the region. CREMS will also continue to operate an active volunteer EMS response based in Kenny Lake and materially support responders throughout the region. CREMS volunteers are still encouraged and expected to respond to 911 medical emergencies when they are available and within their level of comfort.

CREMS as an organization is ready and willing to utilize all its available resources to better support and enhance EMS service throughout the entire Copper Basin.

This may not be as simple as a switch that we can flip, but, we do not intend to sit on our hands (or resources) and complain about what we cannot control.

However, at this time, CREMS cannot and will not expect or require its volunteers in Kenny Lake to provide ambulance transport for patients.

CREMS responders may choose to only respond to the scene in their personal vehicle without providing ambulance transport OR they may respond in the ambulance and transport patients to Gulkana Airport for medevac service if responders are available and comfortable doing so.

CREMS volunteer responders cannot be put in the position of transporting a patient with nowhere in the Copper Basin to take them and CREMS will not transport patients to Valdez, Palmer, or Anchorage area hospitals.

CREMS responders cannot be put in the position of encouraging or accepting patients’ refusal of medical care or transport simply because the patient does not want to be flown to Anchorage or transported out of area by another ambulance service.



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