With hospital closure, comes challenges for EMS

Photo by Andrea Merritt Nathaniel Hunter prepares Callaway County Ambulance District truck for 911 calls on Aug. 11, 2023.

Lack of access to local effective medical treatment poses issues for the people of Fulton.

The Callaway County Ambulance District in Fulton experienced more long transport times and more minor calls after the Callaway County Community Hospital closed.

The Callaway County Ambulance District serves all of Callaway County. The county is 847 square miles and has a population of 44,762, according to the U.S. Census Bureau.

There are ambulance bases in Fulton, Kingdom City and Holts Summit. In Fulton, the base has 2 ambulance trucks and one supervisor truck.

In 2020, the Fulton base served 3,027 total calls, according to the Callaway County Ambulance Board meeting minutes. The ambulance district transported 269 patients to the Callaway Community Hospital in 2020, according to the minutes.

The Callaway Community Hospital in Fulton closed in early 2022.

In 2022, the base served 3,263 total calls, according to the minutes. For the first three months of 2022, the ambulance district transported 67 patients to the Fulton Hospital, the minutes said.

One of the biggest struggles of the job is the large call volume, said Brandon Uebinger, a paramedic for the Fulton base. Some days the district has to run "call, after call, after call," Uebinger said.

Without a local hospital, the ambulance district experiences more 911 calls for minor injuries that could be served at a small hospital or clinic, Uebinger said.

This puts the ambulance out of service, which means EMS can't respond to major calls during that time, Uebinger explained.

The ambulance district typically transports patients to hospitals in Columbia and Jefferson City, according to 2023 board minutes.

The ambulance might spend 30 minutes getting to a call, 15 minutes on the scene, 40 minutes driving to the hospital, another 10 to 15 minutes dropping the patient off and then 30 minutes back, Uebinger explained.

A lack of local, higher-level medical access also increases transport time to necessary care, leading to more time away from medical resources, Uebinger said.

Uebinger explained if a patient was seriously injured, when the hospital was available, they could stabilize the patient, then send them to the local hospital for things like a blood draw.

"It just adds more stress and just more and more things to do," Uebinger said. "Knowing that you don't have a hospital here in town you have to manage, you know, a very serious patient for a longer amount of time."

One of the challenges with long transportation times is that EMS has to "run through the whole algorithm of care," said Nathaniel Hunter, EMT for the Fulton base.

"When you're in Colombia, you're five to 10 minutes away from the hospital," Hunter said "You can do so many things in that period of time, but usually you're not getting through the full scope of your practice."

A lack of local medical access can also lead to a larger medical bill.

In addition to patient care, the ambulance also charges per mile transported. When patients with minor injuries need to be transported to other towns, they may have to pay more, explained Tim Corbitt, shift supervisor for the Fulton base.

The Callaway Community Hospital plans to reopen as ZivaMedical Fulton. The date of reopening is still unknown.

ZivaMedical Fulton will contain an emergency department, ambulatory surgery center, diagnostic imaging, laboratory services, primary care clinic and specialty clinics, according to a previous Fulton Sun article.

However, for injuries like a heart attack, stroke or major car accident, patients will still have to be transported to another hospital, Corbitt said.

"I can't imagine we're gonna have a tremendously big hospital, so we're still gonna have to transport the majority of our patients out, but any hospital that would be in town could definitely benefit the county," Corbitt said.

  photo  Photo by Andrea Merritt Callaway County Ambulance District gear at Fulton base on Aug. 11, 2023.
  photo  Photo by Andrea Merritt Brandon Uerbinger, a paramedic for Callaway County Ambulance District, washs an ambulance truck on Aug. 11 2023.
  photo  Photo by Andrea Merritt Crew member of the Callaway County Ambulance District waashs ambulance truck on Aug. 11 2023.