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Rural growth prompts ambulance response time debate

As the population in the rural areas of Haywood County grows, leaders are being faced with the question of whether it’s time to station new ambulances in these outlying areas.


Response time is also affected as people build higher and higher on the mountainsides, sending ambulances up long, winding roads. When ambulances are dispatched to more remote locations, they are tied up for longer periods and out of commission from the central population bases.

As a result, Emergency Medical Services in Haywood County is recommending two new ambulances to be stationed in the outer regions. The new ambulances would provide quicker response in once-rural areas and free up the in-town ambulances to focus on the population centers. Specifically, Emergency Services is recommending ambulances be stationed in the Bethel and Crabtree area.

“That’s where you have large tracts of land becoming developed,” said Greg Shuping, director of Emergency Services.

Emergency Services recently performed an analysis of EMS response times. The analysis was prompted by a petition from the Cruso community calling for an ambulance to be stationed in their area.

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“We figured, ‘Let’s look at the entire system,’” Shuping said.

The county now has four EMS ambulances: one in Waynesville, Canton, Clyde and Maggie Valley. Ideally, each ambulance would serve its zone, Shuping said. In reality, that’s not how it works.

“Basically everybody is just in one bucket,” Shuping said. “As soon as they tell the dispatcher at 911 they’ve finished a call, they are assigned the next call where ever that may be.”

Shuping made the pitch to Haywood County commissioners in January for two new ambulances and ambulance bays in Bethel and Crabtree. Commissioners said they had to weigh the demand for ambulance service countywide versus those two areas.

“By putting ambulances in these two locations, are we serving the majority of people or just putting them in a geographic location where they can reach remote areas?” Commissioner Kirk Kirkpatrick asked. “Certainly I care about the people in the rural areas, I just want to make sure we have ambulances to serve the greater number of people.”

Shuping said it is a “balancing act” when it comes to response time in remote areas versus the population centers.

Another trend that mirrors development patterns is the number of year-round EMS calls. Until recently, 911 calls ballooned in the summer due to the influx of vacationers and summer residents. As the number of newcomers rise — from baby-boomer retirees to young folks looking for small-town life — and second-home owners opt to spend more and more time here, that summer-time balloon has all but disappeared.

“It used to really drop off in the winter months, but that’s not so anymore,” Shuping said. “The trend appears to be turning so it’s year-round.”

The Haywood County Rescue Squad — a volunteer network of first responders — play an integral role in emergency response, especially in those remote areas, Shuping said. The rescue squad volunteers are alerted when a 911 call goes off in their area. They jump in their own cars and trucks and race to the scene, often arriving ahead of the EMS ambulance. They can stop bleeding, give CPR and other aid until the EMS ambulance gets there.

The rescue squad also has it own ambulances, which pinch-hit on calls when EMS can’t make it. There are only four EMS ambulances in the county. Sometimes all four are tied up when a fifth or sixth call comes through, Shuping said.

“If we are out of ambulances, we call them,” Shuping said. “They do a great job but obviously as volunteers they can be at work or at home in bed, not out riding around in the ambulance. They have to leave where they’re at and get into the station and pick up the ambulance first before responding.”

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