Western Carroll County's Emergency Medical Responders, or EMRs, are critically important in many 911 medical calls and can make a life-or-death difference.
That's why a shortage of them in any of the rural areas is a serious matter -- and right now, each of the four Western District rural fire departments has a serious shortage in several areas, with those most in need of help being Grassy Knob and rural Eureka Springs.
EMRs, who mostly respond from home, are usually the first on scene to a medical call, often reaching patients within 2 to 4 minutes. By contrast, sometimes -- depending on the location of the original call for help -- it can take an ambulance anywhere from 10 to 20 minutes or longer to reach the patient.
In July, the EMR Alliance released a map showing the residence locations of EMRs throughout the Western District. As can be seen on the accompanying map, the Eureka Springs rural area, colored pink, outside the city limits (marked by orange bars), is the largest of the four rural fire districts. Its boundaries extend on Highway 23 North to the CR 266 bridge, Highway 62 West uphill from the Leatherwood Bridge and all of Lake Leatherwood, Highway 23 South to the county line past Turpentine Creek, Highway 62 East to Kings River Bridge, Rockhouse Road to the Kings River Bridge and Onyx Cave Road to CR 216.
There are nine listed active EMR volunteers covering the entire Eureka rural area. Of those, only six actually live in that fire district. Two live in Holiday Island and one lives in Madison County. The concentration of EMRs is in the southern half of Eureka rural. The northern portion is virtually uncovered.
"Some live just outside the area or are in the area or the city and respond," said Randy Ates, Alliance representative for Eureka Rural. "We need people who live in the more remote areas of Buck Mountain (Hogscald), Rockhouse Road, Onyx Cave Road and 62 East."
The other three rural districts are Holiday Island (green), Grassy Knob (yellow), and Inspiration Point (orange). Grassy Knob shows eight EMRs, but there are actually only seven, and of those, only four or five respond regularly, said Lynn Palmer, Alliance chairman, who is also an EMT from Grassy Knob.
"The others sometimes do, and there is one who hasn't responded in about a year and a half, but has equipment just in case."
As can be seen from the map, most of Grassy Knob's responders live in the southern portion, along Beaver Lake, leaving the central and northern portions of the district uncovered.
"We need more help around the dam, Highway 187," Palmer said. "The population is pretty low, but we do have calls during the summer with the tourists, and some water-related emergencies. Grassy Knob does not have a rescue boat, but most emergencies are in the campgrounds. We've had a couple calls off Starkey's Marina, but just borrowed a pontoon, with permission."
Although EMRs do respond to calls in the uncovered areas of their respective fire districts, it takes them longer to get there. Often, mutual aid is needed from an adjacent department, and they are usually glad to help, as every department's first priority is treating patients quickly. But they are not always available.
An EMR is a volunteer trained in basic first aid, CPR and the use of an Automatic External Defibrillator (AED). EMRs take a 40-hour class, which meets four hours a night, twice a week, for five weeks. The EMR class is taught every other year. The next one will be in 2014.
An EMT (Emergency Medical Technician) takes an 80 to 90-hour class, which meets twice a week, said Eureka Springs Fire Chief Rhys Williams. EMTs, on the other hand, learn everything EMRs learn and are trained additionally to splint fractures and to hook up leads for heart monitors.
They are also licensed to accompany a Paramedic on an ambulance.
"They spend more time with hands-on skills, using the equipment on the ambulance," Williams said.
The next EMT class will be taught in January 2013.
Williams said the teachers test skills both in class and on ambulance calls.
But not just anyone can become an EMR or an EMT. It takes a certain temperament, Williams said.
"I strongly recommend people take a class to see if they can handle situations like loss of blood, major trauma or death," he said. "They can get halfway through the class and see if it works for them."
Holiday Island Fire Chief Jack Deaton has people who are interested ride out on calls with responders to see how they do and whether they can handle trauma situations.
Williams said there have been several people in past years who "hung it up."
"It was no fault of theirs -- some people are just not cut out for it."
Classes and training materials for rural EMRs and EMTs are provided free of charge as long as they commit to join their fire department as responders and meet the requirements for response and continuing education. An EMR must respond to a percentage of the calls in the area they are assigned to and complete 18 hours of continuing education units (ceu's) each year, which is not hard to do, as both the Eureka Springs and rural departments offer several kinds of classes each year. EMRs are also covered by workers' compensation if injured while on a call.
Once an EMR is trained, he or she receives a medical bag with supplies, safety equipment, vest, AED and radio. EMRs can, if they want, purchase a red strobe light for their vehicle and can run it while responding to calls as long as they are affiliated with a fire department.
Although many volunteers are both firefighters and EMRs, it is not required. Many EMRs don't want to be firefighters or can't meet the physical requirements for the job. EMRs do work under the direction of the rural fire chiefs and are part of the EMR Alliance. Many EMRs also respond to fire calls to be on standby and as support for the firefighters, who may need monitoring, rehydration or other treatment.
In two of the four departments, Grassy Knob and Inspiration Point, even those who don't want to become EMRs can help out by being traffic directors. Sometimes it is next to impossible for an ambulance to find a rural address, especially in situations where mailboxes are at the entrance to a dirt road and house numbers are not clearly marked. Sometimes local road names don't match what Dispatch has or road signs are missing. The help of traffic directors might mean the difference between life and death.
Most volunteers join their fire departments through contact or invitation from neighbors, coworkers or friends who are involved, but newcomers to a community might like to get involved if they learn through other sources, such as the local media, that there is a need, said Eureka rural Alliance representative Randy Ates.
"Anything that will help bring more people in is a good thing."
Williams said getting the numbers of EMRs up is important.
"We do live in an area that is relatively safe, but one of these days we might have a disaster and will need everyone on deck to get through it," he said. "The more people we have trained, the more it would be a great asset to the department and the community."
And the reward? It's not financial, although some departments are able to compensate small amounts for gas cost.
"The biggest reward is knowing you've helped saved someone's life," said Williams. "Since I started doing this work, I've seen several people I know wouldn't be here if it weren't for the medical responders.
"It takes someone who has a big heart and is willing to get out and help their friends and neighbors and their community."
To sign up for the EMT class in January or to find out more about getting involved, contact the fire chief or Alliance representative in your area. Eureka Springs: Rhys Williams, 253-9616 or Randy Ates, 244-0604; Grassy Knob: Bob McVey, 253-9528 or Karen Finkeldei, 363-9661; Holiday Island: Jack Deaton, 253-8397; Inspiration Point: Tom Kavanagh, 253-4098 or Ed Thompson, 918-691-6093.