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Keeping the trucks running

EMS continues to struggle with vehicle issues

By: Jeremy D. Wells
Carter County Times

Emergency ambulance executive director Rick Loperfido told the board this month that the service had once again been experiencing some issues with their vehicles last month – but thankfully only minor issues. 

One truck was down due to an exhaust leak around the manifold, Loperfido told the board. The same truck had the same issue “about a year ago” he said, but it was on the left side of the engine at that time. Now, he said, it’s on the left. 

They’ve also experienced several issues with another truck over the past month. That vehicle needed a water pump replacement, and then had a coolant line connector fail, causing the engine to malfunction. 

A third vehicle had the rear cooling fans replaced, while a fourth unit is having issues with a leaking fuel tank and had to have a clutch fan replaced in its cooling system. 

Despite these vehicle issues, the service has continued to keep pace, answering 3,399 calls for the year as of July, putting the service 106 runs ahead of their totals for the previous year – that’s even with the July calls being down by ten compared with the same month in 2021. 

Loperfido said a number of those calls have from Carter Nursing Healthcare Facility, telling the board their “runs have dramatically increased” to the facility, with an increasing number of those calls related to “altered mental status.” 

“It’s mostly calls for older individuals experiencing some sort of dementia,” Loperfido told the Times. Others, he said, are experiencing altered states due to “high ammonia levels” from urinary tract infections or other bladder or liver related issues.
 
High ammonia levels can lead to confusion, disorientation, and lethargy. 

Not all of the calls for “altered mental status” come from the nursing home, however, or from underlying medical conditions. 

“We do have several that we get who have (symptoms of) chronic alcoholism,” Loperfido said. If the jail is unable to take them until they sober up, he said, or there is risk of complications they do sometimes transport them to the hospital. 

In personnel matters, he told the court the service had been down one paramedic, after one of their staff injured a knee, putting themselves out of commission for four weeks. This led to some excess overtime, he said, which was unexpected, but that employee has now been released to return to work. 

They were also able to mitigate some of that overtime cost by providing extra coverage for the Carter County Fair, staffing their emergency response pickup truck with one paramedic at the fairgrounds each evening. He said his hope with that plan was to “provide the additional coverage needed and lessen our (overtime) costs as well.”

Loperfido also updated the board on equipment and training programs.
 
In the financial report Valerie Nolan told the board that income for the month of July was $333,002.17 – from $158,577.20 in service revenue, $12.049.10 in enhanced Medicaid payments (less $9,013 for assessment payment), $21,108.73 in tax revenue, $2.09 in interest, and a one-time payment of $150,000 from fiscal court ARPA funds.

But while this was $77,697.17 more than budgeted for the month, and just over $56 thousand more than the same month last year, expenses for the month were $303,141.83; eating up most of the revenue. These costs included $249,213.94 in payroll, $5,498.72 for vehicle repairs and maintenance, and $19,472.68 for vehicle fuel – among other costs – with all expenses together coming in at $61,636.43 over budget for the month. 

Contact the writer at editor@cartercountytimes.com

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