Escondido Firefighters’ Paramedic Role Expanded

The Escondido Fire Department’s paramedics, who now carry about 70% of the victims of car accidents and other emergencies to Palomar Medical Center’s trauma center, will become virtually the exclusive emergency transport in Escondido, the City Council decided Wednesday.

Until now, paramedics transported the more seriously injured victims and deferred to Hartson Medical Services to carry the less seriously injured.

But Fire Chief Bob Watts said there were more disadvantages than advantages to that policy and said Hartson has no objection to backing out of the emergency transport business in Escondido so it can focus on scheduled, nonemergency patient transfers between facilities.

Under the old policy, both paramedics and Hartson would be called to an accident scene and, depending on the evaluation of the patient, one or the other would take the person to Palomar. In about 70% of the cases, the patient was injured badly enough to justify the greater skill of the Fire Department’s paramedics.

The old logic held that, if the patient wasn’t seriously injured, Hartson could take the patient to the hospital, thereby freeing the paramedics for another call.

But Watts noted that it often took more time for paramedics to wait for Hartson to arrive than to take the patient to the hospital immediately themselves.

Furthermore, there was the risk that a patient, once aboard a Hartson ambulance, could take a turn for the worse and need paramedic attention.

Hartson was also burdened by having to provide the backup ambulance in Escondido, even though it was usually not needed, Watts said. Because of the greater profit to Hartson in handling nonemergency transports, the city will receive additional revenue based on its franchise agreement with the private company.

Under the new policy, Hartson will respond to an accident only when paramedics are not immediately available because they are committed elsewhere.