NCFPD reviews response times, ambulance availability if hospital closes

A report given at the March 26 North County Fire Protection District board meeting indicated that the fire department is meeting response time standards in the more populated areas of the district. A separate discussion took place regarding how ambulance availability would be impacted locally if Fallbrook Hospital were to close.

Division chief Gary Lane and fire engineer Eddie Jones gave the 2012 response times report. “This is just an annual report that we deliver to the board that measures our response time against performance goals that the board adopted several years ago,” said NCFPD fire chief Bill Metcalf. “We are very close to achieving our response time goals in the downtown and more densely populated areas of our district.”

The total response time considered in the fire district annual report covers call processing time, turnout time, and travel time. The term “response time” is considered by the fire service to start when the call is received by the emergency communications center and to end when the first fire engine or ambulance arrives on the scene. For the public “response time” starts when an emergency happens and ends when the negative effects of the fire or medical situation are mitigated.

Factors such as fuel, oxygen, and resistive material cause the time between a fire’s ignition and flashover to vary from between three and 30 minutes. The chance of survival after cardiac arrest decreases by seven to 10 percent each minute after the incident while neurological damage from cardiac arrest is considered irreversible after 10 minutes; basic life support should be available within four minutes and advanced life support should be available within eight minutes. All NCFPD ambulances have advanced life support although the ambulance from Camp Pendleton’s Station 9, which sometimes provides automatic aid to NCFPD, has basic life support capabilities.

The NCFPD standards include call processing time, or the time from when the phone is picked up and the first unit is assigned, to be within 60 seconds for 90 percent of the calls. In 2012, 83.4 percent of calls were processed within one minute. Although that does not meet the district’s standard, it is an improvement over the 81.3 percent rate of 2011 and the 79.9 percent figure from 2010. The 2010 rate was a decline from the 2009 rate of 80.3 percent.

NCFPD’s standards also call for 90 percent of incidents to have a turnout time of less than two minutes. In 2012, the turnout time was under two minutes for 92.1 percent of the calls, meeting the standard for the first time. The rate of turnout time under two minutes was 89.2 percent in 2011, 82.9 percent during 2010, and 84.2 percent for 2009.

The report also noted the rate of turnout times under two minutes by station. Station 1 (Ivy Street) had a 2012 rate of 91.18 percent compared to 88.11 percent for 2011. Station 2 (Winterwarm) had a 2012 rate of 94.07 percent and a 2011 rate of 86.16 percent. Station 3 (Olive Hill) had rates of 86.66 percent for 2012 and 85.92 percent for 2011. Station 4 (Pala Mesa) had rates of 84.79 percent in 2012 and 78.65 percent in 2011. Station 5 (Bonsall) had a 2012 rate of 88.42 percent and a 2011 rate of 83.82 percent.

Potential adjustment processes give the district some control over factors such as call processing time and departure from the station after the call is received. “We’ve had some pretty dramatic improvements in that area,” Lane said. “Where we seem to struggle most is our travel time.”

The response times are longer further away from the more populated areas. “We don’t do as well,” Metcalf said. “We knew that going in.”

The travel time standard is within five minutes 90 percent of the time. During 2012 the rate was 79.0 percent in urban areas, 37.2 percent in suburban areas, and 38.7 percent in rural areas. The rates for urban areas were 79.5 percent in 2011, 81.7 percent for 2010, and 81.5 percent during 2009. The rates for suburban areas were 36.8 percent during 2011, 30.6 percent for 2010, and 31.6 percent in 2009. The rural rates were 41.6 percent in 2011, 36.9 percent for 2010, and 37.9 percent during 2009.

“The big challenge here is the road network,” Metcalf said. “There’s only so fast our apparatus can drive over the existing road network.”

“Our downtown area is much more dense with cross-connected streets,” Lane said. “We struggle more in the suburban and rural areas than we do in the downtown area.”

If a second unit is needed, the target arrival time is within 10 minutes of the reported incident. That happened 84.5 percent of the time in urban areas, 50.0 percent of the time in suburban areas, and 43.2 percent of the time in rural areas. If a third unit is needed for a coordinated fire attack the average time is 13 minutes and 7 seconds and the median time is 12 minutes and 29 seconds while 70 percent of the incidents have such arrival time within 16 minutes and 80 percent of such calls have a third unit within 18 minutes.

“We still have room for improvement in some of the most distant portions of the district,” Metcalf said. “We continue to tinker, to look for different options.”

Some of those options may involve a change in deployment of resources between different stations.

“Basically the solution is to build more fire stations, and obviously that’s not going to happen in this economy,” Metcalf said. “We’re making slight improvements, but the big leaps in improvement are going to come from building more fire stations someday.”

“I don’t expect any dramatic changes in the fire district that is going to fix this condition any time soon,” Lane said.

The decrease in urban area rates which meet standards may be due to several factors. “Our number of calls increased last year, mostly due to the increase in the number of fires,” Metcalf said.

If a fire engine or ambulance is in use for another incident, dispatch from a more distant station may be required. “One of the problems we have Downtown is multiple simultaneous calls,” Metcalf said.

The need for multiple ambulances may increase should Fallbrook Hospital close, as has been discussed in the wake of the hospital’s recent financial downturns. “That’s a situation that we’re watching very closely,” Metcalf said.

Currently approximately 60 percent of patients transported by NCFPD ambulances are taken to Fallbrook Hospital. “The ambulance turns around and it’s available again within 30 to 45 minutes,” Metcalf said.

If a patient had to be transported to Palomar Hospital or Tri-City Hospital instead of Fallbrook Hospital, the ambulance may be unavailable for one to two hours. “It would have a significant impact on our ability to provide service because our ambulances would be gone so much longer,” Metcalf said.

The performance report did not consider automatic aid calls to outside the district boundaries. “We only looked within the district for those performance standards,” Lane said.