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<br />MEMO TO: Rod Visser, Assistant County Manager <br />FROM: Nick Waters, Director of Emergency Management <br />DATE: September 10, 1998 <br />RE: Reallocation of Funds to Purchase 12-Lead Defibrillators <br />Emergency Management (EM) staff and Dr. Greg Mears have spent a considerable <br />amount of time evaluating the need for new defibrillators as compazed to the need for <br />a replacement ambulance. As you recall, in 1990, EM staff recommended changing <br />the type ambulances from vans to modular units (patient care compartments can be <br />removed and placed on different chassis). It was predicted that by making this <br />change and by going to diesel engines instead of gasoline engines, that a greater life <br />expectancy for units would be obtained, thereby decreasing the frequency of unit <br />replacement. The modular type ambulances would also allow for unit refurbishment <br />(for example, replacement of the chassis) instead of always replacing the whole <br />ambulance. A total refurbishment would cost approximately one third the cost of <br />purchasing a new unit. Between 1991 and 1994, EM replaced two ambulances a year <br />and now has a total of six modulaz ambulances. The County has not replaced any <br />ambulance since 1994. Prior to this change from vans to modulaz ambulances, the <br />County was purchasing two ambulances per yeaz. <br />An evaluation of the current fleet shows the ambulance mileage ranges from 75,000 <br />to 186,000. All vehicles aze in sound mechanical condition and staff feels we can <br />operate another yeaz without major mechanical problems or excessive down times. <br />The unit scheduled for replacement this yeaz can last another year, as a special event <br />and back up response unit to cover when others aze off line for maintenance. This <br />unit is one of the van type units that EMS will continue to operate since it fits in tight <br />places, more readily than the modulaz type, and is used to cover special events, ball <br />games, automobile races, or for special responses in off-road situations. <br />Dr. Mears and staff believe that use of the approved capital funds to acquire four <br />monitors will have a more positive influence on overall patient outcomes than will an <br />ambulance replacement, at this time. Delaying that replacement by one year should <br />not have an adverse effect on the long-term replacement or refurbishment of the EMS <br />fleet. <br />Paramedics now use monitor defibrillators that aze known as LifePak l Os. These <br />units are limited to 3-lead electro-cazdiograms (ECG) with single lead tracing and <br />monitoring, and to the defibrillation. This means that the paramedics aze precluded <br />from performing additional diagnostic and life support skills on patients suffering <br />from cazdiac events, because of the limitations inherent in the older technology that is <br />currently available to them. <br />3 <br />The newer technology (12-lead monitor defibrillators) has the capability of <br />performing many more functions. These new machines can have options that allow <br />for external cardiac pacing in certain dysrhythmias and the ability to monitor oxygen <br />