California Fire News - Updates in your mail box

Link to California Fire News - Structure, Wildland, EMS

SFFD: 911 improvements decrease response times

Posted: 03 Jan 2009 03:48 PM CST

S.F. 911 response is faster

Following a new protocol, San Francisco's 911 Call Center has reduced the time it takes dispatchers to process emergency medical calls and send help.

First responders in the city are showing up late for 1 of every 5 urgent medical calls, according to The Chronicle's analysis of dispatch logs, an improvement over the previous four years, when delays occurred in about 1 of 4 cases.

The call center's progress has been instrumental in reducing the overall response times of the Fire Department's ambulances and fire engines, whose paramedics and emergency medical technicians are most often the first to arrive at medical emergencies.

In November 2007, the center at 1011 Turk St. began instructing its call-takers to immediately dispatch help to callers reporting priority symptoms. A previous policy required dispatchers to spend additional time gathering more information on the patient's symptoms before sending help.

"Every day, we are seeking improvement," said Lisa Hoffmann, who runs the 911 Call Center. "Our staff is doing an incredible job under almost impossible conditions."

Nathan Ballard, press secretary for Mayor Gavin Newsom, said: "When you call 911, you deserve a quick response. We're pleased with the progress we've made."

The improvement follows a Chronicle investigation of dispatch logs for more than 200,000 high-priority medical calls, along with an examination of documents and audio recordings related to the performance of dispatchers and medics in cases involving delayed responses and fatalities.

6 1/2-minute goal

San Francisco's objective is to get professional help to the scene of high-priority medical emergencies within 6 1/2 minutes of receiving a 911 call, 90 percent of the time. That standard, adopted in 2004 by the San Francisco Emergency Medical Services Agency, was less stringent than a five-minute goal for urban areas recommended in 1998 by the EMS Emergency Medical Directors Association of California.

The Chronicle found that at least 439 people died in San Francisco from February 2004 through December 2007 while waiting for a late ambulance or after delayed medical help arrived. While it is impossible to know how many of those people would have survived had medical help arrived earlier, studies show a direct relationship between ambulance delays and the survival rates of patients in need of immediate resuscitation.

From November 2003 through the end of 2007, emergency medical help arrived late 27 percent of the time on the most serious medical calls, termed Echo and Code 3. But during the first 11 months of this year, help arrived late 20 percent of the time.

The 6 1/2-minute goal includes two minutes for dispatch, plus 4 1/2 minutes for the fire engine or ambulance to arrive at the curb.

From January through November, the call center's call-takers and dispatchers met the city's goal of sending medical help within two minutes of receiving a 911 medical call about 64 percent of the time. A previous Chronicle analysis found that the call center met the city's two-minute goal only 44 percent of the time from November 2003 through the end of 2007 - making it the weakest link in San Francisco's emergency medical response system.

The 911 Call Center "has a rigorous program for quality assurance," said Hoffmann, adding that specialists listen in on some 911 calls to gauge a call-taker's performance. "Every single employee is monitored every month," she said.

Reasons for delays

Dispatch delays are often unavoidable, Hoffman said, because English is not the primary language of many of San Francisco's 911 callers, and the use of translators can slow the process. Other delays occur because of difficulty identifying a caller's address when a cell phone is used, and because some 911 callers are distraught.

While dispatchers are sending help more quickly, ambulances and fire engines are taking longer to arrive at the scene of high-priority medical calls. From January through November, these first responders failed about 18 percent of the time to meet the city's goal of arriving on scene within 4 1/2 minutes of being dispatched. By contrast, ambulances and fire engines were late 15 percent of the time from November 2003 through 2007.

Assistant Deputy Fire Chief Pete Howes attributed the delays to an increase in calls and adjustments being made by paramedics using new electronic patient charts that demand more time at hospitals than paper records.

Some medics complain there are not enough ambulances on duty, which increases the delays for the first units. Fire Chief Joanne Hayes-White disagreed and added: "Particularly with this economy, I don't see us expanding."

For the first 11 months of the year, the city's first responders arrived on the scene of urgent medical calls within seven minutes and 35 seconds 90 percent of the time. That's an improvement from the previous four years, when the city's 90th percentile for the first units on scene was eight minutes.

Service remains the worst in the Ingleside and Excelsior districts and nearby areas, with delays 29 percent of the time. The city's best response times are recorded in the Haight-Ashbury, Cole Valley and nearby neighborhoods, with a delay rate of 14 percent.

Source: SF Gate - Link

Site sought for Cedar fire memorial

Posted: 03 Jan 2009 12:21 PM CST

By Michele Clock, staff writer

2:00 a.m. January 3, 2009

LAKESIDE — The donations began pouring in almost immediately after the Cedar fire roared through Lakeside's dry hills in October 2003. Everyone liked the idea of a memorial honoring those who were killed, including 12 Lakeside residents.

Five years later, a memorial is not yet in place.

Lakeside Historical Society volunteers spent more than $2,000 to design and build a pair of 2-by-3-foot panels that illustrate the fire's path and pay tribute to firefighters and those who died. But the panels sit at the nonprofit's headquarters, mired by what volunteers describe as a lengthy, emotionally wrenching process of researching and designing the panels, confusion over where they could go and a policy barring them from county parks.

For years the society's plan was to place one of the memorials at Lakeside's centerpiece park, Lindo Lake Park. But the county's Department of Parks and Recreation instituted a policy that allows only flagpoles, benches and drinking fountains to be donated as memorials.

Some society members and residents say they are disappointed.

"It's a shame and it's horrible," said Arnold Cutler, who works as a dentist in Lakeside and donated money for the memorial. "It certainly isn't going to hurt anybody and will give some solace to people . . . and hopefully prevent further tragedies from happening."

The society plans to place the other memorial at the society's headquarters in the coming months.

The Cedar fire devastated Lakeside, burning about 300 homes in the area. Residents recall surreal scenes of embers falling from black skies, sirens blaring and emergency evacuations.

"It was mass panic," Cutler said.

The county's Department of Parks and Recreation gets only a few requests each year for memorials, said Renee Hilton, assistant director of the department. The current policy became official in 2005, although some parks already had their own memorial policies, Hilton said.

Early in the planning process, society volunteers sought a park location because a policy did not yet exist, said Richard White, a past historical society president who led a memorial committee.

"They said they needed to come up with a policy before they could tell us yes or no," White said. "If they would have said no right up front, that would have been that. But they didn't."

Society volunteers thought they would have a better chance of approval by including information on the dangers of fires going back to the early 20th century – especially once they learned of the policy. They also thought a more informative approach would help educate the public.

The panels, finished this year, include a graphic of the Cedar fire's path, as well as a somber recognition of those who died, and sharp words for the hunter who pleaded guilty to starting it.

In the background are drawings sketched by local students, and in one corner are photos of 14 of the fire's 15 victims, 12 of them from Lakeside.

The work was emotionally challenging, said Gordon Shackelford, a historical society volunteer who researched archives for the project. Discussions about what kind of memorial to build were difficult, he said.

"Those are not such easy decisions, particularly where you have had such a loss of life," Shackelford said. "This was the biggest disaster Lakeside had ever seen . . . These are not easy things to get through, to get settled on. Not at all."

Randy Ford, a county district park manager, said he was sensitive to the community's loss but the department had to enforce its policy. He said county parks are "geared toward a more positive recreational experience."

County Supervisor Dianne Jacob said she thought that the historical society's concept was good, but that there may be better places for the memorials.

"Our parks are active parks, places for people to enjoy," Jacob said. There are "parks that are specifically memorial parks, and that's a different park, with a different purpose."

Other county parks departments in the state have similar memorial policies.

In Orange County, the parks department lacks a written policy on memorials, but a spokeswoman said they are limited for a similar reason – an overabundance of memorials could detract from the theme or purpose of the park.

In Northern California's Santa Clara County, the Parks and Recreation Department has a policy allowing plaques and monuments under certain circumstances. Officials said they have worked with residents to come up with plans that work for both sides, such as a picnic area in honor of an 18-year-old killed after he fell down a park ravine about five years ago.

Shackelford said the historical society will look for another location to replace Lindo Lake Park.

"Would we have done it any differently? The answer is no," Shackelford said. "In the end we had to create what we felt is the proper item."

Michele Clock: (619) 593-4964; michele.clock@uniontrib.com

Source: SignonSanDiego.com

From the Lakeside Historical Society website:

Statistics

Started in the afternoon of October 25, 2003 in the Cedar Creek Falls Area.
This was the worst fire in California history.
The fire spread at a rate of 3600 acres per hour in the first 36 hours. At one point, it spread 40,000 acres in one hour.
113 injuries
15 deaths
2,232 homes destroyed
53 homes damaged
22 commercial properties destroyed
566 additional structures destroyed
Estimated cost of fighting the fire: More than $31 million dollars.
Cause: Authorities believe it started when a lost hunter set a signal fire that continued to spread.
280,278 acres
Containment Date: 03 Nov 2003
Control date: 05 Dec 2003