Four emergency medical technicians (EMTs) and two drivers worked at the Washington Volunteer Fire and Rescue Department (WVFR) one recent afternoon. The Rappahannock County emergency dispatcher called: There was a traffic accident on U.S. 211 near the Sperryville Schoolhouse. Within seconds, the six volunteers jumped into two ambulances and sped away to help.
Scenes similar to this occurred 600 times in 2011. That’s an average of two to three fire or rescue calls a day. The large majority, 90 percent, were medical calls.
Because of its central location, and Advanced Life Support (ALS) capabilities (that it shares with the Sperryville and Amissville rescue squads), the Washington company runs a lot of calls.
About 50 people are involved with the department. More than half are EMTs and/or firefighters, and the rest are support staff, who contribute by raising funds and processing paperwork. And all members are, of course, volunteers. People contribute what they can, said Russ Collins, the EMT captain. There is no pressure to commit more time or effort.
Chief Gary Jenkins heads up the group. He took over leadership a year and a half ago, after assisting the former chief, Ann Spieker.
“I love doing what I do, helping people,” Jenkins said.
“Once you run an EMS call or a fire call, you get hooked,” Spieker said. “The bug has bitten. You want more.”
Service runs in the families of some volunteers. Amanda Smoot is an EMT. Now 21, she joined the company five years ago. Her mother is an EMT. Her father and brother are firefighters. Volunteering in emergency services is a also a tradition in Collins’s family; his wife, Mary, is the company’s treasurer.
Helping the community is important to Collins, too. He spends two or three hours at the station five days a week, plus he runs calls.
Part of his time this past year was taken up with the WVFR’s big project of implementing an electrocardiogram (EKG) program.
Back in December 2010, Collins talked with their medical director about flying patients with suspected heart attacks directly to Fairfax or Charlottesvile to hospitals that have cardiac catheterization labs, or cath labs, as they are known. Cath labs have specialized equipment to treat heart attacks.
As it was, patients were transported to the nearest hospital; if doctors there diagnosed a heart attack based in part on EKG readings, they might need to be transported again. Two and half hours might pass before the patient got the best treatment.
In a heart attack, oxygen is blocked from reaching the heart, Collins said. Heart muscle deteriorates. The artery needs to be opened to prevent additional degradation of the heart muscle.
“Time is muscle, as the saying goes,” Collins said. Heart muscle does not regenerate. A delay affects the patient’s quality of life.
But, the medical director did not feel comfortable with EMTs making the diagnosis of heart attack based on field EKG readings.
Winchester already had a program in place where local ambulances transmitted EKG feeds directly to Winchester Medical Center. There, a doctor reads the strip of data. If he or she confirms the heart attack diagnosis, EMTs take the patient straight to the medical center, which has a cath lab. From Rappahannock County, this is about a 45-minute trip.
The Washington department decided that a program like Winchester’s was the best way to go.
New equipment was installed on Washington’s two ambulances. Each ambulance carries a sophisticated EKG machine that costs $25,000, according to Collins. The equipment to transmit the EKG reading costs $7,000 to outfit the ambulances. And there’s an ongoing monthly data charge of $80.
The Washington crew implemented the EKG transmittal program in July 2011.
To date, Washington EMTs used the transmitter with two patients.
One night before Thanksgiving, they were called to a Sperryville home. Sperryville EMTs were already there, and had asked for the Washington crew because it looked like a heart attack in progress. The patient complained of severe chest pains, and Collins knew him to be a pretty tough guy. But, the pain could have come from a previous injury. The EKG indicated that the man might be having a heart attack.
There was little conversation on the drive to Winchester. The patient was conscious and still in pain.
In Winchester, the doctors cleared the blocked artery and performed a bypass operation. Collins hears the patient is doing well.
Just a few days later, the Washington EMTs went to an older man’s home in Flint Hill. He suffered from chronic health problems. This patient had all the classic symptoms of a heart attack.
Upon their arrival at the Winchester Medical Center, Collins offered the head surgeon the EKG printout. The doctor waved it away. He had already read it on his smart phone and assembled a team waiting for the patient.
The next goal, Collins said, is to conduct EKG tests on individuals with suspected heart problems. That way, EMTs would have a normal EKG to compare to the EKG that is done when the patient may be having a heart attack.
Collins remembers a call where an older man’s heart and lungs were failing. The patient actually died as they wheeled him through the hospital emergency room doors. Four ambulance people worked with six hospital staff to revive him. He lived.
Sometimes EMTs hear from patients once they are well. Amanda Smoot recalled one evening, while she was working alone at the station, that a man came in. Smoot had seen him once before, a week and a half ago, when he was in bad shape from a traffic accident. Smoot had stayed with him for 45 minutes before he was flown to a hospital. That night he had come to thank the EMTs for their efforts.
“I could not help but smile,” Smoot said. They became friends.
Firefighters have memories, too, of course. The brush fire in February 2011 stands out for Jenkins. Flames covered 780 acres of Tiger Valley and the Long Mountain Road area. Washington sent every truck they had except for one ambulance. Every company in the county sent one to four vehicles. Battling the fire alongside them were crews from Culpeper, Fauquier and Page counties.
Jenkins tells of one Washington firefighter who tried to take a brush truck “into the black,” an area already burned by the fire, which is a safer place for firefighters than areas that are essentially still fields of fuel waiting to burn.
But, he said, the firefighter could only enter this field through a gate in front of the fire. At first, flames burned below the truck. Suddenly, flames flared upward. The brush truck was engulfed.
The driver quickly threw the truck’s into reverse and escaped.
It was a challenge to bring that fire under control, said Jenkins. After it was contained, the crew added up the cost from equipment damage. Soot got into the engine of their attack truck, then the pump broke.
“It was a costly fire,” Jenkins said.
Washington VFRD gets funding in four ways. The county government gives them an annual sum from the Fire Levy Fund. Spieker said they could not exist without it. They also receive donations and grants, and hold fundraisers.
“We’re running a $150,000 to $180,000 business here,” Collins said.
Jenkins said that it is difficult to raise enough money. They host breakfasts and dinners, and an annual Texas Hold’em event. The hall is available for rent, and the Auxiliary runs a Thrift Store next door.
Finally, “we’re very good grant-writers in this company,” Spieker said.
Just as with finding money, finding new members is an ongoing problem, said Jenkins, especially young ones.
“They are the future of the fire department,” Jenkins said. Presently, there are six members in their 20s, and two teenagers. Three of the six adults are career firefighters or medics.
Spieker suggests prospective EMTs ride along on calls before they commit time to training. She has seen individuals realize they cannot do it.
On the firefighter side, one is limited by not being able to enter a burning building without training. However, one can help outside or fight brush fires to start building experience.
Even so, at times it still does not work out.
“You do have structure fires where the new boy goes in, comes out and says, ‘That’s it. I ain’t doing this again,’ ” said Spieker. “I’ve seen it happen.”
“You have those others who just eat up the danger,” said Spieker. She sums up a description of firefighters and EMTs.
“You almost have to be a Type A personality,” she said. “That’s a go-getter who doesn’t want to wait for things, who just wants to go out and do it.”