Carroll discusses COVID-related EMS expenses


The COVID-19 pandemic has caused many new issues and challenges for those in the emergency services field, and Carroll County is certainly no different.

During its July 13 meeting, the Carroll County Board of Supervisors heard from Carroll County EMS Director Gary Bergeron and Keith Schlabach, who held the position in an interim role after former EMS Director Everett Lineberry left the position for a similar job in Wythe County. During discussions of COVID-19 related expenses, Schlabach told supervisors the first thing needed to be done was to remount an ambulance at a cost of approximately $173,053.

”When we run a COVID patient, which we run multiple, it takes I would say a minimum of an hour to (sanitize) an ambulance. So that truck comes out of service a minimum hour length of time,” Schlabach said. “We do have an aging fleet. We don’t always have an old truck to go to as calls come in because some are out of service with engine problems and so forth. So we are requesting remount at that cost of $173,000.”

Several other costs needed to be covered for the county’s EMS system as a whole, Schlabach said, including a chest compression system at a total cost of $211,434. He noted it is considered a high-risk procedure to provide CPR on someone who has a respiratory illness such as COVID-19.

“The American Heart Association, along with multiple other organizations, have come out with a recommendation to maintain as much distancing as we can while providing CPR or high-risk procedures on someone. They have come out and said things such as manual CPR is a possible transmission route,” Schlabach said. “During CPR, the operator performing, his aerobic activity increases, therefore putting them at greater risk. Ventilating a patient during CPR is obviously an increased risk as well, and during CPR we rotate providers every two minutes, and so that is a lot of people that can become exposed during one single call. This would help to mitigate that county-wide, not just for Carroll Fire and Rescue.”

Number two on the list is a McGrath video/scope used for another high-risk procedure for patients with respiratory illness. Carroll Fire and Rescue currently has four of the McGrath devices.

“We would like to put them on the rest of the trucks in Carroll County, that way we can help reduce the risk to providers when they are intubating someone with a respiratory illness,” Schlabach said. “Also with these two things we have been working on trying to come up with a countywide standard so if I get on a Pipers Gap truck or if I get on a Laurel truck or get on my truck, we know what equipment is going to be there. I don’t have to quickly relearn what I am using during that time, so this would go a long way to reducing risk to the riders, and we can jump on whatever truck in the county and have the same equipment.”

The third item on list was relatively inexpensive items, Schlabach said, such as blood pressure cuffs that must be disposed of once a provider has used them on a possible COVID-19 patient. Other similar items include Sp02 sensors, gloves, gowns, and N-95 masks.

”Things like that, that is a larger cost to the county as a whole than what we have been having in the past, and then just other COVID-related expenses such as disposable CPAP, all things we are using during COVID, once again at kind of an increased cost,” Schlabach said. “Some of these things are reusable in the past and right now the best practice is to not reuse them because it is not as easy to sanitize them afterward. That is our request.”

Carroll County Interim Administrator Cellell Dalton said the county needed to be careful with how it breaks down Cares Act funding. The county received nearly $2.6 million in Cares Act money, but must share money with the Town of Hillsville. Since Carroll Fire and Rescue benefits county and town residents, its funding was taken off the top of the funds, with the rest to be shared on a prorated basis.

“Much like what the school system is facing, this is kind of uncharted territory. And when you’re discussing the allocation of these funds, if anything it keeps your attention to the items that further protect our providers during those high-risk procedures,” Bergeron told the board. “Unfortunately, we are dealing with potential exposures and there is a quarantine time, and fortunately these tests have all come back negative, but when we have providers out during a quarantine period that short-staffs the station and so these items would further protect our providers during the high-risk procedures. It’s not just Carroll Fire and rescue personnel, but our countywide volunteers, the key word there is a volunteer. Your heart has to go out to them because they’re making the choice to step through the door for no other reason than to help their neighbor during that point, so I just ask you to keep that in mind during that allocation.”

Supervisor Rex Hill asked if it would be possible to have someone from the county’s EMS system dressed in full COVID-19 gear. Bergeron said they would be glad to do that.

After COVID-19 expense discussions, Supervisor Joe Webb said back in January he approached Schlabach and Cellell Dalton about an improvement plan for emergency services in Laurel Fork. Webb wanted to know if there had been any progress.

“So we have talked with the Captain of Laurel Fork and his request was to let them have a meeting and discuss going to a first-response agency,” Schlabach said. “At that point it would be discussion with the board on what they want to do moving forward, what we can support going forward as far as providing coverage to them.”

So Laurel Fork doesn’t have any better coverage than they did have, Webb asked? Schlabach said it is currently the same as it was before.

“The reason I asked, I am getting a lot of calls. We raised their taxes and they expect something for their taxes and they are asking me when are they going to get better coverage out here, so that is the reason I ask,” Webb said.

Allen Worrell can be reached at (276) 779-4062 or on Twitter@AWorrellTCN

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