Ambulance staffing solution: Go driver only and have the patient sit in the front seat. MD officials want to know why you must have two.

In Frederick County, Maryland, the leadership of the Fire and Rescue Services Division had to spend part of last Tuesday morning telling a Board of County Commissioners meeting why it wouldn’t be prudent to change state law requiring a minimum staffing of two people on basic life support units.

Director Gene Mellin and Bureau Chief Doug Brown had to first explain to County Manager Ronald Hart when a station in the combined system finds itself with a driver only who is an EMT, the unit will often respond to a nearby emergency. It has to do so, not as an ambulance, but as a special unit. Staffing is usually added at the scene and the unit is upgraded, or the special unit provides care until a fully staffed BLS unit arrives.

Chief Brown explained the reason the unit can’t respond as an ambulance is it would not meet the minimum staffing requirements set up by the Maryland Institute for Emergency Medical Services Systems (MIEMSS). Ronald Hart wanted to know how to go about changing the state regulations.

That was followed by Commissioner Kai J. Hagen who thought there were occasions that it might be okay to not only respond to the scene driver only, but to transport to the hospital with the same staffing and have the patient sit in the front seat.

Hagen said, “I could see somebody who had a certain injury, or bleeding, or they are just concerned about potential internal trauma, but they seem fine. Or a snake bite. Do you always have to, absolutely no matter what, have a second person in the vehicle?”

Chief Brown did most of the talking on this topic. Brown nicely explained he didn’t see a reason to try and change state regulations on staffing. The chief also said, beside the need to have an EMT to monitor the patient’s condition, it was important to have the driver concentrate on the task of driving.

You can watch the conversation here. This part of the hearing begins about 1:22. The exchange over BLS staffing starts around 1:29.