Report Cites Problems in Emergency Services : Medical: The study urges the hiring of more personnel to monitor private ambulance operators.

A consultant has found a number of holes in the emergency medical services offered to Ventura County residents, including deficiencies in the county’s 911 dispatch system as well as staffing and supervision of ambulance services.

The consultant’s report, released Wednesday, recommended professional training for all 911 dispatchers and said the county should hire additional personnel to more closely monitor the quality of service provided by the county’s three private ambulance operators.

Each of the ambulance operators should also provide two paramedics on each unit covering heavily populated areas whenever possible, according to the report by the Sacramento-based consultant George V. Moorhead. The report, which cost the county $25,000, took six months to complete.

“My feeling is that it is pretty accurate,” Barbara Brodfuehrer, county emergency services director, said of the report’s conclusions. “There are areas that we need to clean up.”

But Brodfuehrer said county officials are already moving to improve emergency medical services.

She said the County Board of Supervisors on Tuesday authorized the use of electric defibrillators by firefighters to jolt the hearts of cardiac-arrest patients. The board approved training 340 firefighters by June 1, when trucks at all 32 county fire stations will be equipped with the electroshock defibrillators. Moorhead’s report had recommended that a defibrillator program be implemented.

Brodfuehrer also said supervisors are expected in June to require that all ambulance operators provide two paramedics in each station covering heavily populated areas, and at least one paramedic in stations serving rural areas.

The suggested requirements would mean additional paramedics at ambulance stations in all county cities except Moorpark and Camarillo, which already have two-paramedic teams.

Some of the stations now have one paramedic and one emergency medical technician to answer distress calls. Emergency medical technicians, or EMTs, can administer basic life support, such as supplying oxygen or performing cardiopulmonary resuscitation.

Paramedics, who receive more training and get higher salaries, can dispense medication, apply intravenous fluids and work directly with doctors.

The report said the county should move cautiously toward establishing a program to train firefighters as paramedics after determining the costs to the county and how it would affect the three private ambulance companies.

Brodfuehrer said she will follow the report’s suggestion and will request that supervisors add two new positions to her agency, which oversees all emergency services in the county. She said one proposed position would be a data analyst, who could keep more accurate records of the county’s emergency services. The other position would be for a person to continually monitor, review and evaluate the delivery of emergency services.

The biggest concern is the county’s 911 dispatch system, Brodfuehrer said. The report said most 911 dispatchers lack the training to “provide a caller with instructions on what to do until help arrives” and do not provide enough information to ambulance personnel.

Brodfuehrer said the county could require training for 911 dispatchers, but that this would not resolve the question of who would pay for such training. If training were mandatory, she said, then ambulance operators as well as fire and law enforcement officials could demand that the county pay for it.

Moorhead’s report also stated that under the current 911 system, callers often face a lag in time before reaching the proper agency because there is no standardized way of routing calls. The consultant recommended that all public safety dispatch services be consolidated into one central dispatch center.

The report suggested that county officials re-evaluate the response times required of various ambulance services to both cities and rural areas, based on new census information.

Peter Morton, an official with Gulf Coast Ambulance Services of Oxnard, said the new paramedic staffing requirements would greatly improve emergency service.

But Steve Murphy, chief administrator for Pruner, said his company does not believe it is necessary to require two paramedics in heavily populated areas, citing a study last year that showed no service difference between teams with one paramedic and one emergency service technician and those with two paramedics.

Pruner, the largest ambulance operator, covers all of the county except Oxnard, Port Hueneme and Ojai. For that reason, Pruner would be the most heavily affected by the new staffing requirements.

Ojai Ambulance does not handle enough distress calls to be affected by the proposed requirements for more paramedics.