Department ends medical runs

If you call 911 for a medical problem in Nashville or Washington Township, you’ll get an EMT, a paramedic and an ambulance, but not a volunteer first responder from the Nashville station.

At midnight March 31, Brown County (Nashville) Volunteer Fire Department is discontinuing its first responder service, citing a lack of volunteers and an abundance of medical runs.

Volunteer firefighters from the station in town will still respond to crashes, fires and other types of rescues, including those in the state park.

But the only time a Brown County Fire first responder will come to a call about difficulty breathing, a nosebleed, a heart attack, a fall or other medical problem is when both Columbus Regional Hospital ambulances are out of the county, said Chief Dallas “Dak” Kelp.

The new policy will not affect callers from Hamblen, Jackson or Van Buren townships. It will only affect the area served by Brown County (Nashville) Fire, which roughly follows the Washington Township line.

Brown County Dispatch Supervisor Kay Followell said the new plan is to dispatch a first responder from the next-closest volunteer fire department if the call sounds like it’s life-threatening, such as a heart problem, “person down,” excessive bleeding, difficulty breathing, an allergic reaction or “unknown problem.”

“We’re going to have to make more judgment calls and hope people are very patient with us,” Followell said.


Kelp told the Nashville Town Council on Feb. 18 that firefighters were anticipating cutting first responder service. “I think that’s wise,” said town council President Charles “Buzz” King.

In an email two days later, Kelp announced it to the sheriff’s department, dispatch and Columbus Regional Hospital’s ambulance manager.

In 2015, 323 of Brown County Fire’s 612 runs were for medical reasons other than vehicle crashes. Ninety-three times on their way to a call, those volunteers were told that they were no longer needed at the scene.

At the time of the February town council meeting, Brown County Fire had recently learned that about half of its volunteers were quitting.

“If twice a day, you’re being called out on first response runs, you’d kind of get tired of it. It may be one of the reasons you can’t keep people,” King said.

Kelp’s email said the policy could be reevaluated if “staffing levels and run volume change significantly in the future.”

What they do

Columbus Regional Hospital staffs the Brown County ambulance base on State Road 46 East with four trained medical responders on 24-hour shifts, seven days a week. It’s less than a mile from the Brown County Fire station in Nashville.A total of 14 staff work full-time in Brown County. One paramedic and one emergency technician staff each of CRH’s two ambulances, said Adam Hoskins, manager of ambulance services for CRH.Hoskins said Kelp’s email came as a surprise.

In Bartholomew County, where CRH also provides ambulance service, all volunteer fire departments provide first responders when those volunteers are available, Hoskins said.

“It’s hard to predict how it’s going to affect our service to the community. We’ll have to wait it out and evaluate the situation after we get some data,” he said.

Kelp said it was rare anyway for one of his volunteer firefighters to get to a medical call before an ambulance. And if they did, the department’s policy, for liability reasons, wouldn’t allow the volunteer to perform any medical service unless they were under the direction of a medically certified staff person, Kelp said.

Hoskins said if the call is about difficulty breathing — a common complaint — an EMR, or certified first responder, could administer oxygen.

For heart attacks, a first responder can drive the ambulance, allowing CRH’s EMT and paramedic to work on the patient on the way to the hospital, Hoskins said.

Kelp said he can’t spare firefighters to act as drivers — which takes them out of the county for an hour or two — especially going into brush fire season, with so few volunteers to call on.

He said he will ask that his department still be dispatched if both CRH ambulances are out, so they will know when they are needed.

Last week, he said that of the six firefighters who plan to stay on past the end of this year, only one has medical training greater than First Aid and CPR.

Other impacts

Local police will continue to assist on medical calls.Most of the time, deputies will go ahead and respond “just in case,” said Sheriff Scott Southerland. All deputies are first aid-trained and carry the anti-opioid-overdose drug Naloxone, and two deputies are EMTs, he said.Southerland said he didn’t think the change would affect the sheriff’s department much.

“I’m confident that if something were happening within Nashville’s jurisdiction and they were really needed, I’m 100 percent confident that they would be there,” he said about trained medical workers.

Cordry Sweetwater Volunteer Fire Department also operates an ambulance service based at the lakes in northern Brown County, separate from CRH. Followell said it is called when both CRH ambulances are out of the area and the emergency is up north.

Columbus Regional Hospital’s contract with Brown County, in effect from Jan. 1, 2016, to Dec. 31, 2020, does not stipulate that firefighter first responders must aid CRH ambulance staff.

It says that “Brown County agrees that the hospital shall be the first responder for emergency medical services during the term of this agreement.”

Hoskins said he had talked with county commissioner Diana Biddle and there are no plans to change the contract or to add more ambulance staff.

In 2015, Brown County paid CRH about $500,000 for ambulance service — a figure that can fluctuate depending on the number of runs each year.

Hoskins said in a written statement last week that CRH values the partnership it has with Brown County Fire, but “regardless of any pending changes to that partnership, EMS services at Columbus Regional Health will continue to provide Brown County with high-quality service.”

At a glance

Between March 1 and 15, Brown County Dispatch logged 37 medical emergency calls.

First responders and an ambulance were called to 14 of them because of the reported severity of the emergency.

For 19 calls, a CRH ambulance was the only agency to respond — 14 times before dawn or during workday hours.

Three times, fire departments arrived at a medical emergency before the ambulance — but only in Fruitdale, Hamblen and Cordry Sweetwater response territories.

Six times, an ambulance arrived at a medical emergency at the same time or within a minute of a police officer or a firefighter first responder. Most of those were in Brown County Fire’s response area.

Two times, town or county officers arrived at a medical emergency before the ambulance. Those were in Jackson Township and in Nashville.

For 13 medical emergency calls, no information was available about who got there first.

Source: Brown County sheriff’s dispatch logs

2015 run stats

Brown County (Nashville) Volunteer Fire Department: 612 total runs, 323 of them medical

Cordry Sweetwater Volunteer Fire Department: 137 total runs

Fruitdale Volunteer Fire Department: 162 total runs, about half medical

Hamblen Township Volunteer Fire Department: 214 total runs

Jackson Township Fire Department: 147 total runs, 74 of them medical (through November 2015)

Van Buren Volunteer Fire Department: 106 total runs

Sources: Fire chiefs, February and March interviews

Supporting firefighters

On Wednesday, March 23, a small group of town and fire department leaders will discuss ways the town could support the fire department.

Brown County (Nashville) Volunteer Fire Department Chief Dallas “Dak” Kelp requested the meeting in February after announcing that he was losing about half his volunteers, some of them due to fatigue from the unpaid job.

He has repeatedly asked the town to look into ways it might be able to pay firefighters.

The meeting will start at 4 p.m. at Town Hall, 200 Commercial St.

Sara Clifford has been raising a family in Brown County since 2005 and leading the Brown County Democrat since late 2009. In addition to editor, she is the beat reporter for town government and writes columns, features and general news stories.